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Journal of Long-Term Effects of Medical Implants

Publicado 4 números por año

ISSN Imprimir: 1050-6934

ISSN En Línea: 1940-4379

SJR: 0.184 SNIP: 0.485 CiteScore™:: 1.1 H-Index: 39

Indexed in

Effectiveness of Negative-Pressure Wound Therapy following Total Hip and Knee Replacements

Volumen 29, Edición 1, 2019, pp. 51-57
DOI: 10.1615/JLongTermEffMedImplants.2019030593
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SINOPSIS

In this review, we assess the effects of negative-pressure wound therapy (NPWT) following primary hip and knee replacement surgery with a systematic review of randomized controlled trials (RCTs). We searched the Cochrane Bone, Joint, and Muscle Trauma Group's Specialized Registry on June 12, 2018; the Cochrane Central Register of Controlled Trials (CENTRAL, 2018, Issue 1); Ovid MEDLINE (1946–2018); and Embase (1980–2018). To identify RCTs, we combined a subject-specific search strategy with a sensitivity-maximizing version of the Cochrane highly sensitive search strategy. Included were RCTs and quasi-RCTs that compare NPWT with other treatments or no treatment following primary hip and knee replacements. We excluded trials that were focused on patients undergoing revision hip or knee replacements or who had pathological bone disease or periprosthetic fractures. Five RCTs met the inclusion criteria and are included in this review, making a total of 382 patients with primary total hip/knee replacements. Included trials were of varying quality, with little consistency in control groups or outcome measures; therefore, a meta-analysis could not be performed. Overall, three RCTs reported no significant differences in primary outcomes after NPWT, in comparison to standard or conventional wound care. One trial reported significant reduction in wound seroma size in patients undergoing primary hip replacements after NPWT, compared to standard dressings (NPWT, 1.97 vs. 5.08 mL [p = 0.021]; n = 19). Finally, one trial that compared NPWT with standard dressings following primary hip/knee replacements (n = 209) reported statistically significant differences that favored NPWT for overall reduction in length of hospital stay (mean difference, 0.9 d, 95% confidence interval [CI], –0.2–2.5; p = 0.07), number of dressing changes (mean difference, 1.7; 95% CI, 0.8–2.5; p = 0.002), and a fourfold reduction in reported postoperative surgical wound complications (8.4% vs. 2.0%; p = 0.06). Cost-effectiveness quality adjusted life years showed greater savings for higher-risk patients (body mass index ≥ 35; ASA ≥ 3). We find no justification for applying NPWT to all postoperative wounds after routine total hip and knee replacement; however, NPWT may benefit selected patients who are at high risk for wound complications.

REFERENCIAS
  1. Argenta LC, Morykwas MJ. , Vacuum-assisted closure: A new method for wound control and treatment: Clinical experience. Annals Plastic Surg. 1997;38(6):563–76; 77.

  2. Scherer SS, Pietramaggiori G, Mathews JC, Prsa MJ, Huang S, Orgill DP. , The mechanism of action of the vacuum- assisted closure device. Plastic Reconstruct Surg. 2008;122(3):786–97.

  3. Orgill DP, Manders EK, Sumpio BE, Lee RC, Attinger CE, Gurtner GC, Ehrlich HP. , The mechanisms of action of vacuum assisted closure: More to learn. Surgery. 2009;146(1):40–51.

  4. Fleischmann W, Strecker W, Bombelli M, Kinzl L. , Vacuum sealing as treatment of soft tissue damage in open fractures. Der Unfallchirurg. 1993;96(9):488–92.

  5. Lefebvre C, Manheimer E, Glanville J. Searching for studies. In: Higgins JPT, Green S, editors. , Cochrane handbook for systematic reviews of interventions, version 510, updated March 2011. United Kingdom: The Cochrane Collaboration; 2011.

  6. Higgins JPT, Altman DG, Sterne JAC. , Assessing risk of bias in included studies. In: Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions version 510, updated March 2011. United Kingdom: The Cochrane Collaboration; 2011.

  7. Howell RD, Hadley S, Strauss E, Pelham FR. , Blister formation with negative pressure dressings after total knee arthroplasty. Curr Ortho Practice. 2011;22(2):176–9.

  8. Pachowsky M, Gusinde J, Klein A, Lehrl S, Schulz-Drost S, Schlechtweg P, Pauser J, Gelse K, Brem MH. , Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty. Int Ortho. 2012;36(4):719–22.

  9. Hansen E, Durinka JB, Costanzo JA, Austin MS, Deirmengian GK. , Negative pressure wound therapy is associated with resolution of incisional drainage in most wounds after hip arthroplasty. Clin Ortho Related Res. 2013;471(10):3230–6.

  10. Brem MH, Bail HJ, Biber R. , Value of incisional negative pressure wound therapy in orthopaedic surgery. Int Wound J. 2014;11(Suppl 1):3–5.

  11. Gillespie BM, Rickard CM, Thalib L, Kang E, Finigan T, Homer A, Lonie G, Pitchford D, Chaboyer W, Use of negative-pressure wound dressings to prevent surgical site complications after primary hip arthroplasty: A pilot RCT. Surg Innovation. 2015;22(5):488–95.

  12. Cooper HJ, Bas MA. , Closed-incision negative-pressure therapy versus antimicrobial dressings after revision hip and knee surgery: A comparative study. J Arthroplasty. 2016;31(5):1047–52.

  13. Karlakki SL, Hamad AK, Whittall C, Graham NM, Banerjee RD, Kuiper JH. , Incisional negative pressure wound therapy dressings (iNPWTd) in routine primary hip and knee arthroplasties: A randomised controlled trial. Bone Joint Res. 2016;5(8):328–37.

  14. Manoharan V, Grant AL, Harris AC, Hazratwala K, Wilkinson MP, McEwen PJ. , Closed incision negative pressure wound therapy vs. conventional dry dressings after primary knee arthroplasty: A randomized controlled study. J Arthroplasty. 2016;31(11):2487–94.

  15. Scalise A, Calamita R, Tartaglione C, Pierangeli M, Bolletta E, Gioacchini M, Gesuita R, Di Benedetto G. , Improving wound healing and preventing surgical site complications of closed surgical incisions: A possible role of incisional negative pressure wound therapy. A systematic review of the literature. Int Wound J. 2016;13(6):1260–81.

  16. Siqueira MB, Ramanathan D, Klika AK, Higuera CA, Barsoum WK. , Role of negative pressure wound therapy in total hip and knee arthroplasty. World J Ortho. 2016;7(1): 30–7.

  17. Cooper HJ, Roc GC, Bas MA, Berliner ZP, Hepinstall MS, Rodriguez JA, Weiner LA., Closed incision negative pressure therapy decreases complications after periprosthetic fracture surgery around the hip and knee. Injury. 2018;49(2):386–91.

  18. Lee GW, Park KS, Kim DY, Shin YR, Yoon TR. , New strategy of closed suction drainage after primary total hip arthroplasty. Acta Ortho Traumatol Turc. 2017;51(3):223–6.

  19. Nherera LM, Trueman P, Karlakki SL. , Cost-effectiveness analysis of single-use negative pressure wound therapy dressings (sNPWT) to reduce surgical site complications (SSC) in routine primary hip and knee replacements. Wound Rep Regen. 2017;25(3):474–82.

  20. Redfern RE, Cameron-Ruetz C, O’Drobinak SK, Chen JT, Beer KJ. , Closed incision negative pressure therapy effects on postoperative infection and surgical site complication after total hip and knee arthroplasty. J Arthroplasty. 2017;32(11):3333–9.

CITADO POR
  1. Smith Dylan, Berdis Galen, Singh Vishavpreet, Caughran Alexander, Bullock Matthew, Postoperative Fluid Collections in Total Joint Arthroplasty: A Narrative Review, Orthopedic Research and Reviews, Volume 14, 2022. Crossref

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