Postoperative wound management with negative pressure wound therapy in knee and hip surgery: a randomised control trial

Sandro Giannini, Antonio Mazzotti, Deianira Luciani, Giada Lullini, Giuseppe Tedesco, Isabella Andreoli, Matteo Cadossi, Cesare Faldini

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To compare the effectiveness in wound healing of negative pressure wound therapy (NPWT) versus a standard dressing in patients who underwent hip or knee revision surgery.

METHOD: Participating patients scheduled for hip and knee prosthetic revision were randomised into two groups: one receiving standard povidone-iodine gauze and patch wound dressing (control group) and the other NPWT over the sutured wound area (NPWT group). Patients were evaluated by means of ASEPSIS score, occurrence of blisters, visual analogue scale (VAS) and dressing changes seven days after surgery. We hypothesised a five-point difference in ASEPSIS scores as clinically relevant.

RESULTS: A total of 110 patients were enrolled in the study. Mean ASEPSIS score was 5.1 for the control group and 3.0 for the NPWT group, with a significant difference in the ASEPSIS score between groups (p<0.001), although this was not clinically relevant. Considering patients with more than three risk factors for healing complication, a statistical difference of >5 points ASEPSIS score was recorded (p<0.0005). Blister occurrence, VAS score and number of dressing changes were significantly lower in the NPWT group.

CONCLUSION: The results of this study do not support the routine use of NPWT after hip and knee revision. However, it could be beneficial for selected patients once specific risk factors for wound healing complications have been determined.

Original languageEnglish
Pages (from-to)520-525
Number of pages6
JournalJournal of wound care
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2 2018

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Negative-Pressure Wound Therapy
Hip
Knee
Bandages
Wounds and Injuries
Blister
Visual Analog Scale
Wound Healing
Povidone-Iodine
Control Groups
Ambulatory Surgical Procedures
Reoperation

Keywords

  • ASEPSIS score
  • negative pressure wound therapy
  • postoperative wound management
  • standard wound dressing

Cite this

Postoperative wound management with negative pressure wound therapy in knee and hip surgery: a randomised control trial. / Giannini, Sandro; Mazzotti, Antonio; Luciani, Deianira; Lullini, Giada; Tedesco, Giuseppe; Andreoli, Isabella; Cadossi, Matteo; Faldini, Cesare.

In: Journal of wound care, Vol. 27, No. 8, 02.08.2018, p. 520-525.

Research output: Contribution to journalArticle

Giannini, Sandro ; Mazzotti, Antonio ; Luciani, Deianira ; Lullini, Giada ; Tedesco, Giuseppe ; Andreoli, Isabella ; Cadossi, Matteo ; Faldini, Cesare. / Postoperative wound management with negative pressure wound therapy in knee and hip surgery: a randomised control trial. In: Journal of wound care. 2018 ; Vol. 27, No. 8. pp. 520-525.
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AU - Tedesco, Giuseppe

AU - Andreoli, Isabella

AU - Cadossi, Matteo

AU - Faldini, Cesare

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AB - OBJECTIVE: To compare the effectiveness in wound healing of negative pressure wound therapy (NPWT) versus a standard dressing in patients who underwent hip or knee revision surgery.METHOD: Participating patients scheduled for hip and knee prosthetic revision were randomised into two groups: one receiving standard povidone-iodine gauze and patch wound dressing (control group) and the other NPWT over the sutured wound area (NPWT group). Patients were evaluated by means of ASEPSIS score, occurrence of blisters, visual analogue scale (VAS) and dressing changes seven days after surgery. We hypothesised a five-point difference in ASEPSIS scores as clinically relevant.RESULTS: A total of 110 patients were enrolled in the study. Mean ASEPSIS score was 5.1 for the control group and 3.0 for the NPWT group, with a significant difference in the ASEPSIS score between groups (p<0.001), although this was not clinically relevant. Considering patients with more than three risk factors for healing complication, a statistical difference of >5 points ASEPSIS score was recorded (p<0.0005). Blister occurrence, VAS score and number of dressing changes were significantly lower in the NPWT group.CONCLUSION: The results of this study do not support the routine use of NPWT after hip and knee revision. However, it could be beneficial for selected patients once specific risk factors for wound healing complications have been determined.

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