title: Modern papineau technique with vacuum-assisted closure.
abstract: We describe a contemporary modification of the Papineau technique by implementing a vacuum-assisted closure (V.A.C.(R)) device in lieu of wet-to-dry dressing changes. The method makes use of a protocol similar to that of Papineau and others for the treatment of chronic osteomyelitis. This protocol includes aggressive excisional debridement of infected or necrotic bone, open bone grafting with cancellous autograft, vacuum-assisted wound closure by secondary intent, and eradication of chronic infection with concomitant parenteral antibiotics. A representative case report is included to illustrate the technique.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0212, USA. michael.archdeacon.uc.edu
authors.forename: Michael T
authors.initials: MT
authors.lastname: Archdeacon
authors.forename: Patrick
authors.initials: P
authors.lastname: Messerschmitt
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001168:Arthritis / Q000209:etiology; D001174:Arthrodesis / Q000009:adverse effects; D016025:Bone Transplantation; D002908:Chronic Disease; D003646:Debridement; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D050723:Fractures, Bone / Q000150:complications / Q000601:surgery; D005597:Fractures, Open / Q000150:complications / Q000601:surgery; D006801:Humans; D009779:Occlusive Dressings; D010019:Osteomyelitis / Q000209:etiology / Q000601:surgery*; D013380:Subtalar Joint; D013530:Surgical Wound Infection / Q000209:etiology; D013628:Talus / Q000293:injuries* / Q000601:surgery; D013978:Tibial Fractures / Q000150:complications / Q000601:surgery*; D014618:Vacuum; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents