Negative pressure wound therapy in orthopaedic post operative infections: Role in implant retention and dead space management

Abstract

Introduction: Postoperative orthopedic infections in the presence of implants require timely and aggressive intervention for eradication of infection. Negative pressure wound therapy (NPWT) is beneficial in wound management and implant retention, ultimately leading to fracture union. Incidentally, the use of NPWT was of great help in reducing dead space, which is responsible for the chronicity of the infection. It results in collapse of the cavity without need for repeated debridement. Aims and Objectives: This study is done to evaluate the role of negative pressure wound therapy in orthopaedic post operative infections and it's role in implant retention and dead space management. Materials and Methods: Thirty-four patients who developed postoperative infections are included in the study. After thorough wound lavage NPWT dressing was applied followed by wound closure either by secondary suturing, skin graft or flap cover. Results: Thirty-four patients were treated during 2012-2014 out of which 22 patients had implants, 2 were treated for dead space, and 10 for both. Conclusion: NPWT has a definite role in eradicating early postoperative infection in the presence of an implant. The greatest advantage is retention of the implant.