Negative Pressure Wound Therapy Post Arthroplasty

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton and Kim Jackson  

Introduction[edit | edit source]

NPWT: use in surgical wound

Negative-pressure wound therapy (NPWT) has been successful used in the wound management of various surgical procedures. NPWT is the application of below atmospheric pressure to the wound, aiming to reduce inflammatory exudate and encourage granulation tissue. It use is mainly used in complex wounds which are non-healing (eg surgical site infections (SSI's), wound dehiscence) or those at risk of non-healing eg diabetics and the obese[1][2].

Use in Total Knee and Total Hip Arthroplasty[edit | edit source]

Due to the calamitous consequences of infection following joint arthroplasty it has found a valuable use here. The pre-emptive use of NPWT after arthroplasty for those at high risk for postoperative wound drainage issues has the most robust clinical evidence. [3]. Current research supports the application of NPWT to reduce the incidence of wound complication and SSI in:

  • High‐risk patients after THA or TKR
  • Revision procedures after THA or TKA[4]

High Risk Group[edit | edit source]

The major risk factors for wound management problematic issues include:

  • Obesity: negatively effects outcomes for those treated with TKA, with both increased short-term and long term complications. eg both SSIs and wound complications are associated with the TKA operations in the obese.
  • Diabetics
  • Tobacco Abuse
  • Malnutrition
  • Older Persons
  • Stress[5]

Viewing[edit | edit source]

This video demonstrates an optimal NPWT application with application tips, system use, and removal of the PICO System. NPWT is indicated for acute and chronic wounds and closed surgical incisions.

[6]

References[edit | edit source]

  1. ↑ Song QC, Li D, Zhao Y, Zhang GY, Shang DL, Fan LH, Dang XQ. Negative pressure wound therapy reduces the incidence of postoperative wound dehiscence and surgical site infections after total knee arthroplasty in patients with obesity. Medicine (Baltimore). 2022 Jul 8;101(27):e29641. doi: 10.1097/MD.0000000000029641. PMID: 35801735; PMCID: PMC9259126. Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9259126/ (accessed 23.12.2023)
  2. ↑ Zaver V, Kankanalu P. Negative Pressure Wound Therapy. 2022 Sep 9. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2023.Available:https://www.ncbi.nlm.nih.gov/books/NBK576388/ (accessed 23.12.2023)
  3. ↑ Siqueira MB, Ramanathan D, Klika AK, Higuera CA, Barsoum WK. Role of negative pressure wound therapy in total hip and knee arthroplasty. World journal of orthopedics. 2016 Jan 1;7(1):30.Available: https://pubmed.ncbi.nlm.nih.gov/26807353/(accessed 23.12.2023)
  4. ↑ Kim JH, Lee DH. Are high‐risk patient and revision arthroplasty effective indications for closed‐incisional negative‐pressure wound therapy after total hip or knee arthroplasty? A systematic review and meta‐analysis. International Wound Journal. 2020 Oct;17(5):1310-22.Available:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7948573/ (accessed 24.12.2023)
  5. ↑ Wernick B, Nahirniak P, Stawicki SP. Impaired wound healing.Available:https://www.ncbi.nlm.nih.gov/books/NBK482254/ (accessed 23.12.2023)
  6. ↑ Smith & Nephew Wound US. Application of the PICO System after knee surgery. Available from: https://www.youtube.com/watch?v=wLXCETLv0nQ [last accessed 23.12.2023]
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