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Negative pressure wound therapy reduces deep infection rate in open tibial fractures.
- Source :
-
Journal of orthopaedic trauma [J Orthop Trauma] 2012 Sep; Vol. 26 (9), pp. 499-505. - Publication Year :
- 2012
-
Abstract
- Objectives: To evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures.<br />Design: Retrospective cohort study. Data was collected from medical records and radiographs.<br />Setting: Two level-1 trauma centers.<br />Patients/participants: Patients who sustained an open tibial fracture which underwent delayed soft tissue coverage between January 2002 and December 2007 were included. Exclusion criteria included open fractures receiving a combination of NPWT and conventional dressings, fractures which were treated with a primary amputation, and fractures associated with mortality.<br />Intervention: : NPWT with reticulated open cell foam or conventional dressings at surgeon's discretion.<br />Main Outcome Measurement: Deep infection rate.<br />Results: A total of 229 open tibial fractures in 220 patients met the inclusion criteria and received either NPWT (166/229-72%) or conventional dressings (63/229-28%). There was a decreased rate of deep infection in the NPWT group compared with the conventional dressing group [8.4% (14/166) vs. 20.6% (13/63); P = 0.01]. Univariate predictors of deep infection included Gustilo type {odds ratio (OR): 3.13 [95% confidence interval (CI): 1.74-5.64]; P < 0.001} and use of NPWT [OR: 0.35 (95% CI: 0.16-0.80); P = 0.01]. When adjustment was performed for Gustilo type with multivariate analysis, use of NPWT was found to reduce the risk of deep infection by almost 80% [OR: 0.22 (95% CI: 0.09-0.55); P = 0.001].<br />Conclusions: These results suggest that NPWT reduces the rate of deep infection when used for the dressing of traumatic wounds in open tibial fractures.<br />Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
- Subjects :
- Adult
Bandages
Cohort Studies
Female
Fractures, Open complications
Humans
Male
Retrospective Studies
Surgical Wound Infection etiology
Tibial Fractures complications
Fractures, Open surgery
Negative-Pressure Wound Therapy
Surgical Wound Infection prevention & control
Tibial Fractures surgery
Wounds and Injuries therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1531-2291
- Volume :
- 26
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of orthopaedic trauma
- Publication Type :
- Academic Journal
- Accession number :
- 22487900
- Full Text :
- https://doi.org/10.1097/BOT.0b013e31824133e3