Negative-Pressure Wound Therapy: Principles and Usage in Orthopedic Surgery

Abstract

Negative-pressure wound therapy (NPWT) is being increasingly used in the management of different types of wounds over the last few decades. It relies on generating a negative pressure on the surface of the wound, which is believed to promote wound healing. Although NPWT is used for various types of chronic wounds, acute wounds, and surgical incisions, not all types of wounds may benefit from NPWT. A thorough understanding of the principles of NPWT is crucial for its appropriate use. This chapter reviews the basic concepts of NPWT and the current evidence in support of its use in various surgical fields, especially orthopedic trauma, total joint arthroplasty (TJA), and orthopedic oncology. NPWT is widely used in trauma patients especially when there are large soft-tissue defects precluding primary closure. The NPWT is also used as prophylactic dressing after hip and knee arthroplasty in high-risk patients. However, well-conducted trials are needed in the future to give definitive answers regarding the clinical superiority of NPWT over the conventional less expensive dressings.