title: Negative Pressure, a "Solution" in the Treatment of Infected Knee Prosthesis?
abstract: BACKGROUND
  Negative-pressure wound therapy is a therapeutic technique that uses a vacuum dressing in order to promote healing in acute or chronic wounds. The continued vacuum draws out fluid from the wound and increases blood flow to the area. The aim of this study was to establish the effectiveness of negative pressure therapy increasing this way the chances of rehabilitation after knee prosthesis infections.
  
  
  METHODS
  11 patients with septic complications after total knee joint replacement were involved into this study, from the Department of Orthopaedic and Traumatology of Bucharest Emergency University Hospital. In all of the cases negative pressure wound treatment was applied. The surgical approach was chosen according to the surgeon's preferences or along the pre-existing surgical approach.
  
  
  CONCLUSIONS
  Time from the knee arthroplasty to the clinical and biological manifestation of septic complications was about 35 days with limits between 21 and 42 days. In most cases we managed to keep the implant, the outcome obviously being conditioned by using the negative pressure. Knee infections are still a hazardous problem in orthopedic surgery. Negative-pressure system increased the granulation tissue formation and the local blood flow and enhanced the bacterial clearance function.
  
  
  CONCLUSIONS
  The clinical outcome in our cases indicates that the Negative-Pressure Wound Therapy can be a valuable contribution to the treatment of knee joint infections.
authors.affiliation: Department of Orthopedics and Traumatology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Razvan
authors.initials: R
authors.lastname: Ene
authors.affiliation: Department of Orthopedics and Traumatology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Zsombor
authors.initials: Z
authors.lastname: Panti
authors.affiliation: Department of Plastic and Reconstructive Surgery, Emergency University Hospital, Bucharest, Romania.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Albu
authors.affiliation: Department of ENT, Emergency University Hospital, Bucharest, Romania.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ene
authors.affiliation: Department of Obstetrics and Gynecology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Monica Mihaela
authors.initials: MM
authors.lastname: Cirstoiu
authors.affiliation: Department of Orthopedics and Traumatology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Florin Catalin
authors.initials: FC
authors.lastname: Cirstoiu
keywords: infection; knee prosthesis; negative-pressure wound therapy; vacuum-assisted closure