Abstract
ABSTRACTObjective: To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems. Methods: We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico(r) device for NPWT in addition to standard treatment of infection or dehiscence in our institution. We considered as an initial favorable outcome the resolution of the infectious process and the closure of the surgical wound dehiscences in the treated cases and the good progression of the wound without complicating events in the prophylactic cases. Results: We evaluated 10 patients who used Pico(r) in our service. All patients had a favorable outcome according to established criteria. No complications were identified regarding the use of the NPWT device. The mean follow-up of the patients after the use of the device was 10.5 months. Conclusion: The NPWT can be safely used in wound infections and complications following TKA with promising results. Long-term randomized prospective studies should be conducted to prove its effectiveness. Level of Evidence IV, Case Series.
Highlights
Total knee arthroplasty (TKA) is an increasingly common surgery
To present an experience with negative-pressure wound therapy (NPWT) in the treatment of surgical wounds in patients treated for infections after total knee arthroplasty (TKA) with or without dehiscence and prophylaxis in wounds considered at risk of healing problems
We prospectively evaluated patients with TKA infection with or without surgical wound dehiscence and patients with risk factors for infection or surgical wound complications treated with Pico® device for NPWT in addition to standard treatment of infection or dehiscence in our institution
Summary
It is estimated that in 2030 nearly 3.5 million TKA procedures will be performed in the United States.[1] As the number of arthroplasties increases, the number of complications resulting from this procedure rises, including surgical wound complications and infection.[2] Known risk factors for skin complications and infection after TKA include diabetes, obesity, poor nutrition, smoking, and especially prior surgeries.[2,3]. More studies are required to investigate each of these clinical situations The objective of this present study is to show our experience with NPWT in treating surgical wounds in patients with infections after TKA, associated with or independent of dehiscence, and as a prophylaxis in wounds considered to be at risk for healing problems
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