First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study

Int Orthop. 2011 Sep;35(9):1415-20. doi: 10.1007/s00264-011-1274-y. Epub 2011 May 17.

Abstract

Purpose: Infections associated with orthopaedic implants remain a serious complication. The main objective in acute infection control is component retention, whereas this option is usually not considered for chronic infections.

Methods: This multi-centre prospective, non-randomised observational study investigated one possible treatment option for implant retention in combination with negative pressure wound therapy with instillation (NPWTi). Thirty-two patients with an infected orthopaedic implant were analysed. Twenty-two patients had an acute infection (< 8 weeks after implantation) and ten patients had a chronic infection (> 8 weeks and < 36 weeks after implant placement). Polyhexanide was used as the instillation solution in 31 of the 32 cases.

Results: Nineteen patients (86.4%) with an acute infection and eight patients (80%) with a chronic infection retained their implant at 4-6 months follow-up after treatment.

Conclusions: Our study showed that NPWTi can be used as adjunctive therapy for salvage of acutely infected orthopaedic implants and may even be considered for early chronically infected implants.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / therapeutic use*
  • Biguanides / therapeutic use*
  • Chronic Disease
  • Combined Modality Therapy
  • Debridement
  • Female
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy / methods*
  • Prospective Studies
  • Prosthesis-Related Infections / therapy*
  • Therapeutic Irrigation
  • Treatment Outcome

Substances

  • Anti-Infective Agents, Local
  • Biguanides
  • polihexanide