title: Closed-Incision Negative-Pressure Therapy Versus Antimicrobial Dressings After Revision Hip and Knee Surgery: A Comparative Study.
abstract: This study evaluates the efficacy of closed-incision negative-pressure therapy (ciNPT) in decreasing wound complications and surgical site infections (SSIs) after revision hip and knee surgery.
  
  
  
  A retrospective quality improvement analysis of 138 consecutive revision hip and knee operations performed by a single surgeon over a 34-month period was performed. ciNPT was used selectively in higher-risk patients with multiple risk factors for SSIs over the last 15 months of the study period. Rates of wound complications, SSIs, and reoperation were compared with patients treated with a sterile antimicrobial dressing.
  
  
  
  Antimicrobial dressings were used in 108 patients, whereas ciNPT was used in 30 patients. Patients treated with ciNPT developed fewer overall wound complications (6.7% vs 26.9%, P = .024) and fewer total SSIs (3.3% vs 18.5%, P = .045) than patients treated with antimicrobial dressings. In addition, there were trends toward a lower rate of superficial wound dehiscence (6.7% vs 19.4%, P = .163), fewer deep periprosthetic joint infections (0.0% vs 9.3%, P = .118), and fewer reoperations (3.3% vs 13.0%, P = .191) among patients treated with ciNPT.
  
  
  
  Our findings suggest that ciNPT may decrease wound complications and SSIs in patients undergoing revision hip and knee surgery.
authors.affiliation: Division of Adult Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital, North Shore-LIJ Health System, New York, New York.
authors.forename: H John
authors.initials: HJ
authors.lastname: Cooper
authors.affiliation: Division of Adult Reconstruction, Department of Orthopaedic Surgery, Lenox Hill Hospital, North Shore-LIJ Health System, New York, New York.
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Bas
mesh_terms: D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001458:Bandages; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000628:therapy; D058996:Quality Improvement; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*
chemical_list: D000890:Anti-Infective Agents
keywords: closed-incision negative-pressure therapy; hip revision; knee revision; prevention; quality improvement; surgical site infections