A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings
| Autor: | A W P Chapman, R Norris, S Krikler, M Krkovic |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Novel technique medicine.medical_specialty Prosthesis-Related Infections Adolescent medicine.medical_treatment Modified method Young Adult Negative-pressure wound therapy Humans Medicine Aged Retrospective Studies business.industry Negative-Pressure Dressings Letters and Comments Vacuum-assisted closure Parenteral antibiotic Modified technique Retrospective cohort study General Medicine Orthopaedic Negative pressure wound therapy Middle Aged Arthroplasty Infected orthopaedic metalwork Anti-Bacterial Agents Orthopedic Fixation Devices Surgery Female business Negative-Pressure Wound Therapy |
| Zdroj: | Annals of The Royal College of Surgeons of England |
| ISSN: | 1478-7083 0035-8843 |
| Popis: | Introduction There has been recent interest in the use of negative pressure wound therapy (NWPT) as an adjunct to parenteral antibiotics in the treatment of infection in orthopaedic patients with metalwork in situ. To address some of the limitations of standard NPWT in this situation, the senior author has developed a modified method of treatment for infected metalwork (excluding arthroplasty) in orthopaedic patients that includes irrigation and skin closure over the standard NPWT dressing. Methods This retrospective study examined the outcome of a case series of 16 trauma and orthopaedic patients with deep infection involving metalwork in whom this modified form of NPWT was used. In conjunction with standard parenteral antibiotic therapy and a multidisciplinary approach, this modified technique included serial debridements in theatre, irrigation and negative pressure dressings over a white polyvinyl alcohol foam (KCI, Kidlington, UK) as well as closure of the skin over the foam. Results Among the 16 patients, there was a variety of upper and lower limb as well as spinal trauma and elective cases. In all 16 patients, there was successful resolution of the infection with no early or unplanned removal of any metalwork required. Conclusions Patients with infected metalwork are a heterogeneous group, and often suffer high morbidity and mortality. The modified NPWT technique shows potential as an adjunct in the treatment of complex orthopaedic patients with infected metalwork. |
| Databáze: | OpenAIRE |
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