Negative pressure wound therapy in total hip and knee arthroplasty: a meta-analysis

Wang, Lei; Xu, Xin; Cao, Jun; Li, Jun

doi:10.2217/cer-2019-0009

Cited by 4 publications

(3 citation statements)

References 22 publications

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“…One potential complication of ciNPT use is the formation of skin blisters, usually found in the peri‐wound skin away from the surgical incision 15,22,37 . This may be related to improper application technique and friction of negative pressure dressing on skin 15,38 . Blisters are more common in patients undergoing TKA 37,38 and with the application of polyurethane foam 22,37 .…”

Section: Discussionmentioning

confidence: 99%

“… 15 , 22 , 37 This may be related to improper application technique and friction of negative pressure dressing on skin. 15 , 38 Blisters are more common in patients undergoing TKA 37 , 38 and with the application of polyurethane foam. 22 , 37 Efforts have been aimed at developing a new kind of silicone foam to decrease blister formation in TKA.…”

Section: Discussionmentioning

confidence: 99%

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Closed‐incision negative pressure therapy at −125 mmHg significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta‐analysis of randomized controlled trials

Elhage

Awad

Irfan

et al. 2022

Health Science Reports

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Background Closed‐incision negative pressure wound therapy (ciNPT) has shown promising effects for managing infected wounds. This meta‐analysis explores the current state of knowledge on ciNPT in orthopedics and addresses whether ciNPT at −125 mmHg or −80 mmHg or conventional dressing reduces the incidence of surgical site complications in hip and knee arthroplasty. Methods This meta‐analysis was conducted according to the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA) guidelines and Cochrane Handbook. Prospective randomized controlled trials (RCTs) with ciNPT use compared to conventional dressings following hip and knee surgeries were considered for inclusion. Non‐stratified and stratified meta‐analyses of six RCTs were conducted to test for confounding and biases. A P value less than .05 was considered statistically significant. Results The included six RCTs have 611 patients. Total hip and knee arthroplasties were performed for 51.7% and 48.2% of the included population, respectively. Of 611 patients, conventional dressings were applied in 315 patients and 296 patients received ciNPT. Two ciNPT systems have been used across the six RCTs; PREVENA Incision Management System (−125 mmHg) (63.1%) and PICO dressing (−80 mmHg) (36.8%). The non‐stratified analysis showed that the ciNPT system had a statistically significant, lower risk of persistent wound drainage as compared to conventional dressing following total hip and knee arthroplasties (OR = 0.28; P = .002). There was no difference between ciNPT and conventional dressings in terms of wound hematoma, blistering, seroma, and dehiscence. The stratified meta‐analysis indicated that patients undergoing treatment with high‐pressure ciNPT (120 mmHg) displayed significantly fewer overall complications and persistent wound drainage (P = .00001 and P = .002, respectively) when compared to low‐pressure ciNPT (80 mmHg) and conventional dressings. In addition, ciNPT is associated with shorter hospital stays. (P = .005). Conclusion When compared to conventional wound dressing and −80 mmHg ciNPT, the use of −125 mmHg ciNPT is recommended in patients undergoing total joint arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Closed‐incision negative pressure therapy at −125 mmHg significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta‐analysis of randomized controlled trials

Elhage

Awad

Irfan

et al. 2022

Health Science Reports

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“…In 2017, an international panel of multidisciplinary experts identified key SSC risk factors and recommendations for the appropriate application of ciNPT 24 . Since then, multiple meta‐analyses have reported an association between ciNPT and reduced SSCs when applied after arthroplasty, 25 abdominal, 13,23,26 vascular, 4,19,22 and caesarean surgery, 27 among other surgery types 14,17,28‐30 …”

Section: Introductionmentioning

confidence: 99%

The use of closed incision negative pressure therapy for incision and surrounding soft tissue management: Expert panel consensus recommendations

Silverman

Apostolides²,

Chatterjee

et al. 2021

International Wound Journal

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As the use of closed incision negative pressure therapy (ciNPT) becomes more widespread, dressing designs have evolved to address implementation challenges and meet surgeon demand. While traditional application of ciNPT was limited to the immediate suture line, a novel dressing that covers the incision and additional surrounding tissues has become available. To expand upon previous ciNPT recommendations and provide guidance on this new dressing, an expert panel of plastic surgeons convened to review the current literature, identify challenges to the implementation and sustainability of ciNPT, and use a modified Delphi technique to form a consensus on the appropriate use of ciNPT with full‐coverage dressings. After three rounds of collecting expert opinion via the Delphi method, consensus was reached if 80% of the panel agreed upon a statement. This manuscript establishes 10 consensus statements regarding when ciNPT with full‐coverage foam dressings should be considered or recommended in the presence of patient or incision risk factors, effective therapeutic settings and duration, precautions for use, and tools and techniques to support application. The panel also discussed areas of interest for future study of ciNPT with full‐coverage dressings. High‐quality, controlled studies are needed to expand the understanding of the benefits of ciNPT over the incision and surrounding tissues.

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Comparison of silver-embedded occlusive dressings and negative pressure wound therapy following total joint arthroplasty in high BMI patients: a randomized controlled trial

Lygrisse

Teo

Singh

et al. 2022

Arch Orthop Trauma Surg

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Negative pressure wound therapy in total hip and knee arthroplasty: a meta-analysis

Cited by 4 publications

References 22 publications

Closed‐incision negative pressure therapy at −125 mmHg significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta‐analysis of randomized controlled trials

Closed‐incision negative pressure therapy at −125 mmHg significantly reduces surgical site complications following total hip and knee arthroplasties: A stratified meta‐analysis of randomized controlled trials

The use of closed incision negative pressure therapy for incision and surrounding soft tissue management: Expert panel consensus recommendations

Comparison of silver-embedded occlusive dressings and negative pressure wound therapy following total joint arthroplasty in high BMI patients: a randomized controlled trial

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