Negative-Pressure Wound Therapy in the Treatment of Complex Injuries After Total Knee Arthroplasty

Helito, Camilo Partezani; Bueno, Daniel Kamura; Giglio, Pedro Nogueira; Bonadio, Marcelo Batista; Pécora, José Ricardo; Demange, Marco Kawamura

doi:10.1590/1413-785220172502169053

Cited by 12 publications

(5 citation statements)

References 30 publications

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“…15 Ene et al conducted a study with infected knee prosthesis and obtained good results (no wound dehiscence and complications) with the use of NPWT. 16 In a series of 10 cases of complex lesions of the knee, Helito et al demonstrated promising results in the healing of wounds and no complications with the use of NPWT. 17 …”

Section: Discussionmentioning

confidence: 99%

Incisional Negative-Pressure Wound Therapy in Revision Total Hip Arthroplasty Due to Infection

et al. 2018

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ObjectiveTo present our institution's experience with negative-pressure wound therapy (NPWT) as an adjuvant in wound healing of patients who have undergone revision total hip arthroplasty (THA) due to septic loosening in the presence of active fistula.MethodsWe prospectively assessed patients presenting with THA infection, associated with the presence of fistula, treated with a PICO® device for NPWT, in combination with the standard treatment for prosthesis infection in our institution. Resolution of the infectious process and healing of the surgical wound without complications were considered an initial favorable outcome.ResultsWe assessed 10 patients who used PICO® in our department. No complications were identified in association with the use of the NPWT device. The mean follow-up of the patients after use of the device was 12.7 months. Only one patient progressed with fistula reactivation and recurrence of infection.ConclusionNPWT can be used in wound complications and infection following THA procedures safely and with promising results. Randomized prospective studies should be conducted to confirm its effectiveness. Level of Evidence IV, Case Series.

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Section: Discussionmentioning

confidence: 99%

Incisional Negative-Pressure Wound Therapy in Revision Total Hip Arthroplasty Due to Infection

et al. 2018

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“…In addition, as an alternative to traditional dressings, negative-pressure wound therapy (NPWT) has been used to effectively treat open wounds in various situations [35,36]. Recently, there is increasing evidence that closed incisional NPWT (ciNPWT) can potentially reduce the risk of surgical site infection, wound complications, reoperation, and decreased length of hospitalization in patients with TKA [37][38][39]. Although we did not use this kind of ciNPWT in our study, it might be a better choice when we encounter severe wound complications in the future.…”

Section: Discussionmentioning

confidence: 99%

Scalpel can achieve better clinical outcomes compared with electric cautery in primary total knee arthroplasty: a comparison study

Lin

Dai

Niu

et al. 2020

BMC Musculoskelet Disord

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Background: Whether using the scalpel can provide better and faster recovery after the primary total knee arthroplasty (TKA) is still controversial. The aim of this research was to compare the clinical outcomes of using the scalpel and the electric cautery in primary TKA. Methods: From January 2016 to December 2017, a retrospective cohort study was conducted in 313 patients who underwent unilateral primary TKA by using the scalpel (group S). During this period, we selected 313 patients who underwent unilateral primary TKA by using the electric cautery (group E) for comparison. The tourniquet time, operative time, blood loss, wound complications, visual analog score for pain, range of motion, Knee Society Score were assessed between the two groups. The Forgotten Joint Score was used to analyze the ability to forget the joint. Results: There were no significant differences in tourniquet time, operative time, blood loss between the two groups (p > 0.05). In the group S, the visual analog score for pain, range of motion, Knee Society Score were found better results at 1 week, 1 month, 3 months, 6 months, 12 months and 24 months after surgery (p < 0.05). Besides, during the follow-up period, the Forgotten Joint Score was significantly higher compared with group E (p < 0.05). Conclusion: In this research, the patients who underwent TKA by using the scalpel could achieve better clinical outcomes. In addition, if forgotten artificial joint after TKA was the final goal, the patients who underwent TKA by using the scalpel would acquire better quality of life.

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“…One of the recent alternatives that has been used to improve wound healing after TKA and to minimize wound complications and the incidence of infection is the use of negative-pressure therapy [ 14 , 15 ]. This type of therapy has been used successfully in several fields of medicine, such as plastic surgery, colorectal surgery and caesarean, and has achieved excellent results in the orthopaedic field, especially in cases of open fractures or open wounds [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention

Helito

Sobrado

Giglio

et al. 2020

BMC Musculoskelet Disord

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Background: Wound healing complications are causal factors of prosthesis infection and poor postoperative evolution of patients after total knee arthroplasty (TKA). Negative-pressure wound therapy (NPWT) can be an option to minimize these complications. The aim of this study is to compare the complications of patients undergoing TKA who used a portable NPWT device in the immediate postoperative period with those of a control group. Methods: A total of 296 patients were evaluated. Patients were divided into two groups: those who used NPWT for seven days in the postoperative period (Group 1prospective evaluated) and those who used conventional dressings (Group 2historical control group). Epidemiological data, comorbidities, local parameters related to the surgical wound and complications were evaluated. Results: The groups did not differ in regard to sex, age and clinical comorbidities. Overall, 153 (51.7%) patients had at least one risk factor for wound complications. Patients who used NPWT had a lower rate of complications (28.5% vs. 45.7%, p = 0.001) and a lower rate of reintervention in the operating room (2% vs. 8.5%, p = 0.001). Patients in group 1 had a lower incidence of hyperaemia (14.7% vs. 40.2%, p = 0.01), skin necrosis (2.1% vs. 8.5%, p = 0.04) and wound dehiscence (3.1% vs 10.1%, p = 0.03). The use of NPWT was a protective factor for the presence of complications, with an odds ratio of 0.36 (95% CI 0.206-0.629). Conclusion: The number of complications related to the wound after TKA is high; however, most of them are minor and have no impact on the treatment and clinical evolution of patients. The use of NPWT decreased the number of surgical wound complications, especially hyperaemia, dehiscence and necrosis, and reduced the need for reintervention.

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Negative-Pressure Wound Therapy in the Treatment of Complex Injuries After Total Knee Arthroplasty

Cited by 12 publications

References 30 publications

Incisional Negative-Pressure Wound Therapy in Revision Total Hip Arthroplasty Due to Infection

Incisional Negative-Pressure Wound Therapy in Revision Total Hip Arthroplasty Due to Infection

Scalpel can achieve better clinical outcomes compared with electric cautery in primary total knee arthroplasty: a comparison study

The use of negative-pressure wound therapy after total knee arthroplasty is effective for reducing complications and the need for reintervention

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