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Clinical Orthopaedics and Related Research®
Published in: Clinical Orthopaedics and Related Research® 10/2013

01-10-2013 | Symposium: 2012 Musculoskeletal Infection Society

Negative Pressure Wound Therapy Is Associated With Resolution of Incisional Drainage in Most Wounds After Hip Arthroplasty

Authors: Erik Hansen, MD, Joel B. Durinka, MD, James A. Costanzo, MD, Matthew S. Austin, MD, Gregory K. Deirmengian, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 10/2013

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Abstract

Background

Persistent wound drainage after hip arthroplasty is a risk factor for periprosthetic infection. Negative pressure wound therapy (NPWT) has been used in other fields for wound management although it is unclear whether the technique is appropriate for total hip arthroplasty.

Questions/purposes

We determined (1) the rate of wound complications related to use of NPWT for persistent incisional drainage after hip arthroplasty; (2) the rate of resolution of incisional drainage using this modality; and (3) risk factors for failure of NPWT for this indication.

Methods

In a pilot study we identified 109 patients in whom NPWT was used after hip arthroplasty for treating postoperative incisional drainage between April 2006 and April 2010. On average, the NPWT was placed on postoperative Day 3 to 4 (range, 2–9 days) and applied for 2 days (range, 1–10 days). We then determined predictors of subsequent surgery. Patients were followed until failure or a minimum of 1 year (average, 29 months; range, 1–62 months).

Results

Eighty-three patients (76%) had no further surgery and 26 patients (24%) had subsequent surgery: 11 had superficial irrigation and débridement (I&D), 12 had deep I&D with none requiring further surgery, and three ultimately had component removal. Predictors of subsequent surgery included international normalized ratio level greater than 2, greater than one prior hip surgery, and device application greater than 48 hours. There were no wound-related complications associated with NPWT.

Conclusions

The majority of our patients had cessation of wound drainage with NPWT.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadata
Title
Negative Pressure Wound Therapy Is Associated With Resolution of Incisional Drainage in Most Wounds After Hip Arthroplasty
Authors
Erik Hansen, MD
Joel B. Durinka, MD
James A. Costanzo, MD
Matthew S. Austin, MD
Gregory K. Deirmengian, MD
Publication date
01-10-2013
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 10/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-2937-3

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