title: First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study.
abstract: OBJECTIVE
  Infections associated with orthopaedic implants remain a serious complication. The main objective in acute infection control is component retention, whereas this option is usually not considered for chronic infections.
  
  
  METHODS
  This multi-centre prospective, non-randomised observational study investigated one possible treatment option for implant retention in combination with negative pressure wound therapy with instillation (NPWTi). Thirty-two patients with an infected orthopaedic implant were analysed. Twenty-two patients had an acute infection (< 8 weeks after implantation) and ten patients had a chronic infection (> 8 weeks and < 36 weeks after implant placement). Polyhexanide was used as the instillation solution in 31 of the 32 cases.
  
  
  RESULTS
  Nineteen patients (86.4%) with an acute infection and eight patients (80%) with a chronic infection retained their implant at 4-6 months follow-up after treatment.
  
  
  CONCLUSIONS
  Our study showed that NPWTi can be used as adjunctive therapy for salvage of acutely infected orthopaedic implants and may even be considered for early chronically infected implants.
authors.affiliation: Department of Orthopedic Oncology and Septic Orthopedic Surgery, Orthopedic University Hospital, Heidelberg, Germany. burkhard.lehner@med.uni-heidelberg.de
authors.forename: Burkhard
authors.initials: B
authors.lastname: Lehner
authors.forename: Wim
authors.initials: W
authors.lastname: Fleischmann
authors.forename: Rolf
authors.initials: R
authors.lastname: Becker
authors.forename: Gerrolt N
authors.initials: GN
authors.lastname: Jukema
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001645:Biguanides / Q000627:therapeutic use*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000628:therapy*; D007507:Therapeutic Irrigation; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D001645:Biguanides; C031233:polihexanide