Journal ArticleDOI
Role of acute negative pressure wound therapy over primarily closed surgical incisions in acetabular fracture ORIF: A prospective randomized trial.
Brett D. Crist,Lasun O. Oladeji,Michael S Khazzam,Gregory J. Della Rocca,Yvonne M. Murtha,James P. Stannard +5 more
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TLDR
iNPWT did not decrease the incidence of deep infections when compared to gauze dressings in patients with acetabular fractures, and patients in the iNPWT cohort were 2.77 times more likely to develop a deep infection.Abstract:
Background Negative pressure wound therapy use over closed surgical incisions (iNPWT) has proven to be effective at reducing hematoma, wound drainage and infection in high-risk wounds. The purpose of this study was to determine if iNPWT decreased the risk of infection in patients undergoing open reduction internal fixation (ORIF) for acetabular fractures. Methods 71 patients who underwent operative intervention for an acetabular fracture between March 2008 and September 2012 consented and prospectively randomized to iNPWT or a standard postoperative (dry gauze) dressing. The primary endpoint was deep infection, i.e. necessitating surgical debridement. Patients were followed until fracture union. Results 33 patients were randomized to treatment with a standard gauze dressing and 33 patients were randomized to the iNPWT cohort. There were no statistically significant differences between the groups with respect to patient demographics, clinical, or surgery characteristics. Overall, seven patients (10.6%) were diagnosed with infections; two patients (6.1%) in the placebo group and 5 (15.2%) in the treatment group. Conclusions In this randomized prospective trial, iNPWT did not decrease the incidence of deep infections when compared to gauze dressings in patients with acetabular fractures. Although not statistically significant, patients in the iNPWT cohort were 2.77 times more likely to develop a deep infection.read more
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Journal ArticleDOI
Negative pressure wound therapy for surgical wounds healing by primary closure
Joan Webster,Zhenmi Liu,Gill Norman,Jo C Dumville,Laura Chiverton,Paul Anthony Scuffham,Monica Stankiewicz,Wendy Chaboyer +7 more
TL;DR: The evidence from 23 studies showed that NPWT may reduce the rate of SSIs, but it is uncertain whether NPWT increases or decreases reoperation rates when compared with a standard dressing, and the evidence to be of low or very low certainty for all outcomes.
Journal ArticleDOI
Effect of Incisional Negative Pressure Wound Therapy vs Standard Wound Dressing on Deep Surgical Site Infection After Surgery for Lower Limb Fractures Associated With Major Trauma: The WHIST Randomized Clinical Trial.
Matthew L. Costa,Juul Achten,Ruth Knight,Julie Bruce,Susan J Dutton,Jason Madan,Melina Dritsaki,Nicholas R. Parsons,M A Fernandez,Richard W. Grant,Jagdeep Nanchahal +10 more
TL;DR: The findings do not support the use of incisional negative pressure wound therapy in this setting, although the event rate at 30 days was lower than expected.
Journal ArticleDOI
Prevention of fracture-related infection: a multidisciplinary care package
Willem-Jan Metsemakers,Jolien Onsea,Emilie Neutjens,Ester Steffens,Annette Schuermans,Martin A. McNally,Stefaan Nijs +6 more
TL;DR: The implementation of these guidelines, together with close collaboration between infection control physicians, surgeons, anaesthesiologists and nursing staff, can potentially have a beneficial effect on the rate of FRI after musculoskeletal trauma surgery.
Journal ArticleDOI
Closed Incision Negative Pressure Therapy Reduces Surgical Site Infections in Vascular Surgery: A Prospective Randomised Trial (AIMS Trial)
Alexander Gombert,Michael Babilon,Mohammad E. Barbati,András P. Keszei,Klaus T. von Trotha,Houman Jalaie,Johannes Kalder,Drosos Kotelis,Andreas Greiner,Stephan Langer,Michael J. Jacobs,Jochen Grommes +11 more
TL;DR: The results confirmed a reduced superficial SSI rate after vascular surgical groin incision using ciNPT compared with standard wound dressings in patients who underwent vascular surgery for peripheral artery disease.
Journal ArticleDOI
The impact of negative pressure wound therapy for closed surgical incisions on surgical site infection: A systematic review and meta-analysis
TL;DR: There is moderate certainty that negative pressure wound therapy applied to closed surgical incisions reduces the risk of surgical site infections across all surgical procedures.
References
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Journal ArticleDOI
Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation.
TL;DR: It is determined that the application of controlled subatmospheric pressure creates an environment that promotes wound healing.
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Fractures of the acetabulum: accuracy of reduction and clinical results in patients managed operatively within three weeks after the injury.
TL;DR: Findings indicate that in many patients who have a complex acetabular fracture the hip joint can be preserved and post-traumatic osteoarthrosis can be avoided if an anatomical reduction is achieved.
Journal ArticleDOI
The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost.
James D. Whitehouse,N. Deborah Friedman,Kathryn B. Kirkland,William J. Richardson,Daniel J. Sexton +4 more
TL;DR: Orthopedic SSIs prolong total hospital stays by a median of 2 weeks per patient, approximately double rehospitalization rates, and increase healthcare costs by more than 300%.
Journal ArticleDOI
Incisional negative pressure wound therapy after high-risk lower extremity fractures.
James P. Stannard,David A. Volgas,Gerald McGwin,Rena L. Stewart,William T. Obremskey,Thomas J. Moore,Jeffrey O. Anglen +6 more
TL;DR: There is a decreased incidence of wound dehiscence and total infections after high-risk fractures when patients have NPWT applied to their surgical incisions after closure, and a strong trend for decreases in acute infections after NPWT.
Journal ArticleDOI
Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma.
James P. Stannard,James T. Robinson,E. Ratcliffe Anderson,Gerald McGwin,David A. Volgas,Jorge E. Alonso +5 more
TL;DR: This ongoing randomized study has demonstrated decreased drainage and improved wound healing following both hematomas and severe fractures, and a significant difference was present at current enrollment for infection or wound breakdown.