Negative pressure wound therapy limits downgrowth in percutaneous devices.
Maintenance of a soft tissue seal around percutaneous devices is challenged by the downgrowth of periprosthetic tissues-a gateway to potential infection. As negative pressure wound therapy (NPWT) is used clinically to facilitate healing of complex soft tissue pathologies, it was hypothesized that NPWT could limit downgrowth of periprosthetic tissues. To test this hypothesis, 20 hairless guinea pigs were randomly assigned into four groups (n = 5/group). Using a One-Stage (Groups 1 and 3) or a Two-Stage (Groups 2 and 4) surgical procedure, each animal was implanted with a titanium-alloy subdermal device porous-coated with commercially pure, medical grade titanium. Each subdermal device had a smooth titanium-alloy percutaneous post. The One-Stage procedure encompassed insertion of a fully assembled device during a single surgery. The Two-Stage procedure involved the implantation of a subdermal device during the first surgery, and then three weeks later, insertion of a percutaneous post. Groups 1 and 2 served as untreated controls and Groups 3 and 4 received NPWT. Four weeks postimplantation of the post, the devices and surrounding tissues were harvested, and histologically evaluated for downgrowth. Within the untreated control groups, the Two-Stage surgical procedure significantly decreased downgrowth (p = 0.027) when compared with the One-Stage procedure. Independent of the surgical procedures performed, NPWT significantly limited downgrowth (p ≤ 0.05) when compared with the untreated controls.
Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah.|Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.|Department of Bioengineering, University of Utah Salt Lake City, Utah.
Saranne J
SJ
Mitchell
Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah.|Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.|Department of Bioengineering, University of Utah Salt Lake City, Utah.
Sujee
S
Jeyapalina
Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah.|Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.
Francesca R
FR
Nichols
Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
Jayant
J
Agarwal
Orthopaedic Research Laboratory, Department of Orthopaedics, University of Utah, Salt Lake City, Utah.|Orthopaedic Research Laboratory, Research Service, George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah.|Department of Bioengineering, University of Utah Salt Lake City, Utah.
Kent N
KN
Bachus
D000497:Alloys; D000818:Animals; D005260:Female; D006168:Guinea Pigs; D054843:Negative-Pressure Wound Therapy; D019736:Prostheses and Implants; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections; D011897:Random Allocation; D012867:Skin / Q000473:pathology*; D013530:Surgical Wound Infection; D014025:Titanium; D014945:Wound Healing
D000497:Alloys; D014025:Titanium