Abstract
Introduction
The incidence of periprosthetic fractures is increasing as the population ages. Wound complications and surgical site infections following surgery to treat periprosthetic fractures are a major source of patient morbidity and health care burden. This study evaluates the efficacy of closed-incision negative-pressure wound therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after periprosthetic fracture surgery about the hip and knee.
Methods
An IRB-approved retrospective quality improvement analysis of sixty-five consecutive periprosthetic fracture surgeries performed by four surgeons at a single institution in a fifteen-year period was performed. ciNPT was selectively used on patients in the last 20 months of the study period. Rates of wound complications, surgical site infections, and reoperation were compared with those of a sterile antimicrobial dressing (AMD).
Results
AMD was used on 44 patients, while ciNPT was used in 21 patients. Compared with those treated with AMD, patients treated with ciPNT developed fewer wound complications 5% (1/21) vs 25% (11/44) (p = 0.045), deep infections 0% (0/21) vs 20% (9/44) (p = 0.014), and underwent fewer reoperations 5% (1/21) vs 20% (9/44) (p = 0.045). All patients had at least thirty days of follow up.
Conclusion
Our findings suggest that ciNPT decreases the incidence of wound complications, deep infections, and reoperations in patients requiring surgical management of periprosthetic fractures about the hip and knee.
