Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A Comparative Study

Abstract

BackgroundThis study evaluates the efficacy of closed-incision negative-pressure therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after revision hip and knee surgery. MethodsA retrospective quality improvement analysis of 138 consecutive revision hip and knee operations performed by a single surgeon over a 34-month period was performed. ciNPT was used selectively in higher-risk patients with multiple risk factors for SSIs over the last 15 months of the study period. Rates of wound complications, SSIs, and reoperation were compared with patients treated with a sterile antimicrobial dressing. ResultsAntimicrobial dressings were used in 108 patients, whereas ciNPT was used in 30 patients. Patients treated with ciNPT developed fewer overall wound complications (6.7% vs 26.9%, P = .024) and fewer total SSIs (3.3% vs 18.5%, P = .045) than patients treated with antimicrobial dressings. In addition, there were trends toward a lower rate of superficial wound dehiscence (6.7% vs 19.4%, P = .163), fewer deep periprosthetic joint infections (0.0% vs 9.3%, P = .118), and fewer reoperations (3.3% vs 13.0%, P = .191) among patients treated with ciNPT. ConclusionOur findings suggest that ciNPT may decrease wound complications and SSIs in patients undergoing revision hip and knee surgery.