INCISIONAL NEGATIVE-PRESSURE WOUND THERAPY IN REVISION TOTAL HIP ARTHROPLASTY DUE TO INFECTION

ABSTRACT Objective: To 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. Methods: We 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. Results: We 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. Conclusion: NPWT 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.

摘要
研究目的：总结本机构针对因感染性松动伴活动性瘘管而行翻修全髋关节置换术（revision total hip arthroplasty, THA）的患者，将负压伤口疗法（negative-pressure wound therapy, NPWT）作为伤口愈合辅助手段的临床应用经验。
研究方法：前瞻性评估本科室收治的合并瘘管的全髋关节置换术感染患者，所有患者均采用PICO®负压伤口治疗设备，并联合本机构假体感染的标准治疗方案。将感染进程得到控制、手术伤口愈合且无并发症视为初步良好结局。
研究结果：本研究共纳入10例使用PICO®设备的患者。未观察到与NPWT设备使用相关的并发症。患者使用设备后的平均随访时长为12.7个月。仅1例患者出现瘘管复发及感染复发。
研究结论：负压伤口疗法（NPWT）可安全应用于全髋关节置换术后的伤口并发症及感染治疗，且疗效可观。未来需开展前瞻性随机对照研究以验证其临床有效性。
证据等级：IV级，病例系列研究。