title: What is the ideal interval between dressing changes during negative pressure wound therapy for open traumatic fractures?
abstract: OBJECTIVE
  Negative pressure wound therapy (NPWT) is effective in infection control during treatment of severe open fractures. However frequent dressing changes during NPWT are costly and cause patient discomfort. If the interval between dressing changes could be extended, these problems would be reduced. In this article we compare the outcomes of open IIIB fractures with 3-day versus 7-day intervals between dressing changes.
  
  
  METHODS
  Patients who sustained Gustilo IIIB open fractures were included. All underwent conventional orthopaedic fixation with delayed latissimus dorsi flap coverage. Group 1 had 3-day intervals between dressing changes and group 2 had 7-day intervals. The final outcomes in the two groups were analysed.
  
  
  RESULTS
  There were 38 patients in group 1 and 34 patients in group 2. Although the period between admission and final operation was similar in the two groups, the mean number of NPWT changes was 4.54 in 3 day in group 1 and 1.95 in group 2 (p<0.001). This led to a difference in NPWT-related costs; $341.26 in group 1 and $237.49 in group 2 (p<0.001). There was no difference in the frequency of complications such as infection or non-union of fractures.
  
  
  CONCLUSIONS
  NPWT is useful treatment option for open fractures, to bridge between initial debridement and final microsurgical tissue transfer. Considering patient comfort, the costs related to the NPWT, and the final flap results, a 7-day interval between changes of the NPWT is acceptable.
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: Y H
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: K T
authors.initials: KT
authors.lastname: Hwang
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea.
authors.forename: J T
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul National University Hospital, Seoul, Korea.
authors.forename: S W
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001458:Bandages; D003362:Cost-Benefit Analysis; D005260:Female; D005597:Fractures, Open / Q000451:nursing / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000191:economics / Q000379:methods*; D056910:Republic of Korea; D012189:Retrospective Studies; D017592:Skin Care / Q000451:nursing*; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
keywords: flap; infection; negative pressure wound therapy; open fracture