APPLICATION OF THE VACUUM-ASSISTED CLOSURE THERAPY IN COMPLEX TREATMENT OF EARLY PERIPROSTHETIC INFECTION AFTER HIP ARTHROPLASTY
https://doi.org/10.24884/0042-4625-2018-177-1-41-44
Abstract
OBJECTIVE. The aim of this study was to improve the results of the complex treatment of early periprosthetic infection in hip replacement by using a vacuum therapy. MATERIAL AND METHODS. The study included 82 patients with periprosthetic infection who had been hospitalized to the department of traumatology and orthopedics federal state budgetary educational Institution of higher education «north-Western state Medical University named after I. I. Mechnikov» from 2008 to 2016. We compared the results of the treatment in the retrospective group (without vacuum therapy) and in the prospective panel (using the local negative pressure method). RESULTS. The studies demonstrated the efficacy of the method of vacuum therapy in combination with standard methods of periprosthetic infection treatment. The clinical effects were: decrease of tissue edema, good reduction of wound exudate, decreasing the concentration of the microflora in the surgical wound area, granulation growth, stimulation of epithelialization, reducing of the time spent in the hospital. CONCLUSION. All these effects lead to the fact that the number of cases where we were able to maintain the implant increased from 52,9 % in retrospective groups to 78,8 % in prospective groups.
About the Authors
I. I. Russu
North-Western State Medical University named after I. I. Mechnikov, Ministry of Healthcare of the Russian Federation, Saint-Petersburg
Russian Federation
Russian Federation
S. A. Linnik
North-Western State Medical University named after I. I. Mechnikov, Ministry of Healthcare of the Russian Federation, Saint-Petersburg
Russian Federation
Russian Federation
A. N. Tkachenko
North-Western State Medical University named after I. I. Mechnikov, Ministry of Healthcare of the Russian Federation, Saint-Petersburg
Russian Federation
Russian Federation
G. E. Kvinikadze
North-Western State Medical University named after I. I. Mechnikov, Ministry of Healthcare of the Russian Federation, Saint-Petersburg
Russian Federation
Russian Federation
I. O. Kucheev
North-Western State Medical University named after I. I. Mechnikov, Ministry of Healthcare of the Russian Federation, Saint-Petersburg
Russian Federation
Russian Federation
References
1. Адмакин А. Л., Лящук С. С., Коваленко А. А. Использование VACсистемы в лечении ран нижних конечностей // Актуальные вопросы клиники, диагностики и лечения в многопрофильном лечебном учреждении : XII Всеросс. науч.практ. конф. СПб. : ВМедА, 2016. С. 4. [Admakin A. L., Ljashhuk S. S., Kovalenko A. A. Ispol’zovanie VACsistemy v lechenii ran nizhnih konechnostej // XII Vseros. nauch.prakt. konf. “Aktual’nye voprosy kliniki, diagnostiki i lechenija v mnogoprofil’nom lechebnom uchrezhdenii”. SPb.: VMedA, 2016. Р. 4].
2. Дорофеев Ю. Л. Прогноз и профилактика глубокой инфекции области хирургического вмешательства при эндопротезировании тазобедренного сустава : автореф. дис. … канд. мед. наук. СПб., 2016. 24 с. [Dorofeev Ju. L. Prognoz i profilaktika glubokoj infekcii oblasti hirurgicheskogo vmeshatel’stva pri jendoprotezirovanii tazobedrennogo sustava: avtoref. dis. … kand. med. Nauk. SPb., 2016. 24 s].
3. Кавалерский Г. М., Мурылев В. Ю., Рукин Я. А., Елизаров П. М., Музыченков А. В. Ревизионная хирургия тазобедренного сустава : роль индивидуальных артикулирующих спейсеров // Кафедра травматол. и ортопедии. 2014. № 4. С. 4–8. [Kavalerskij G. M., Murylev V. Ju., Rukin Ja. A., Elizarov P. M., Muzychenkov A. V. Revizionnaja hirurgija tazobedrennogo sustava: rol’ individual’nyh artikulirujushhih spejserov // Kafedra travmatologii i ortopedii. 2014. № 4. P. 4–8].
4. Неверов В. А. Курбанов С. Х., Серб С. К. Отдалённые результаты эндопротезирования тазобедренного сустава // Вестн. хир. 2011. Т. 170, № 3. С. 96–100. [Neverov V. A., Kurbanov S. H., Serb S. K. Otdaljonnye rezul’taty jendoprotezirovanija tazobedrennogo sustava // Vestnik khirurgii. 2011. Vol. 170, № 3. P. 96–100].
5. Оболенский В. Н. Метод локального отрицательного давления в лечении гнойносептических осложнений эндокоррекции сколиоза // Росс. мед. журн. 2014. № 1. С. 30–35. [Obolenskij V. N. Metod lokal’nogo otricatel’nogo davlenija v lechenii gnojnosepticheskih oslozhnenij jendokorrekcii skolioza // Rossiisky meditsinskiy zhurnal. 2014. № 1. Р. 30–35].
6. Тихилов Р. М., Шубняков И. И. Руководство по хирургии тазобедренного сустава. СПб. : РНИИТО им. Р. Р. Вредена, 2015. Т. 2. 356 с. [Tihilov R. M., Shubnjakov I. I. Rukovodstvo po khirurgii tazobedrennogo sustava. SPb.: RNIITO im. R.R.Vredena, 2015. Vol. 2. 356 p.].
7. Achten J., Parsons N. R., Bruce J., Petrou S., Tutton E., Willett K., Lamb S. E., Costa M. L. Protocol for a randomised controlled trial of standard wound management versus negative pressure wound therapy in the treatment of adult patients with an open fracture of the lower limb : UK Wound management of Open Lower Limb Fractures (UK WOLFF) // BMJ Open. 2015. Vol. 5, № 9. P. 1–10.
8. Chang C. W., Chan H. Z., Lim S. W., Khoo E., Zulkiflee O. Negative pressure wound therapy in infected wound following posterior spinal instrumentation using simple selfassembled system : a case report // Malaysia Orthop. J. 2014. Vol. 8, № 2. P. 49–51.
9. Ene R., Panti Z., Albu E., Ene P., Cirstoiu M.M., Cirstoiu F.C. Negative pressure, a «Solution» in the treatment of infected knee prosthesis? // Maedica (Buchar). 2015. Vol. 10, № 1. P. 5–9.
10. Gage M. J., Yoon R. S., Egol K. A., Liporace F. A. Uses of negative pressure wound therapy in orthopedic trauma // Orthop. Clin. North. Am. 2015. Vol. 46, № 2. P. 227–234.
11. Hansen E., Durinka J. B., Costanzo J. A., Austin M. S., Deirmengian G. K. Negative pressure wound therapy is associated with resolution of incisional drainage in most wounds after hip arthroplasty // Clin. Orthop. Relat. Res. 2013. Vol. 471, № 10. P. 3230–3236.
12. Kelm J., Schmitt E., Anagnostakos K. Vacuumassisted closure in the treatment of early hip joint infections // Int. J. Med. Sci. 2009. Vol. 6, № 5. P. 241–246.
13. Klayman M. H., Trowbridge C. C., Stammers A. H., Wolfgang G. L., Zijerdi D. A., Bitterly T. J. Autologous platelet concentrate and vacuumassisted closure device use in a nonhealing total knee replacement // J. Extra Corpor. Technol. 2006. Vol. 38, № 1. P. 44–47. 14. Lehner B., Fleischmann W., Becker R., Jukema G. N. First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants : a clinical observational study // Int. Orthop. 2011. Vol. 35, № 9. P. 1415–1420.
14. Liu D. S., Sofiadellis F., Ashton M., MacGill K., Webb A. Early soft tissue coverage and negative pressure wound therapy optimises patient outcomes in lower limb trauma // Injury. 2012. Vol. 43, № 6. P. 772–778.
15. Narducci F., Samouelian V., Marchaudon V. Koenig P, Fournier C., Phalippou J., Leblanc E. Vacuumassisted closure therapy in the management of patients undergoing vulvectomy // Eur. J. Obstet. Gynecol. Reprod. Biol. 2012. Vol. 161, № 2. P. 199–201.
16. Pachowsky M., Gusinde J., Klein A., Lehrl S., SchulzDrost S., Schlechtweg P., Pauser J., Gelse K., Brem M.H. Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty // Int. Orthop. 2012. Vol. 36, № 4. P. 719–722.
17. Parvizi J., Jacovides C., Zmistowski B., Jung K. A. Definition of periprosthetic joint infection : is there a consensus? // Clin. Orthop. Relat. Res. 2011. Vol. 469, № 11. P. 3022–3030.
18. Söylemez M. S., Özkan K., Kılıç B., Erinç S. Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections : a report of two cases // Ther. Clin. Risk Manag. 2016. Vol. 10, № 12. P. 161–166.
19. Tsukayama P., Estrada R., Gustilo R. B. Infection after total hip arthroplasty // J. Bone J. Surg. 1996. Vol. 78A, № 4. P. 512–523.
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For citations:
Russu I.I., Linnik S.A., Tkachenko A.N., Kvinikadze G.E., Kucheev I.O. APPLICATION OF THE VACUUM-ASSISTED CLOSURE THERAPY IN COMPLEX TREATMENT OF EARLY PERIPROSTHETIC INFECTION AFTER HIP ARTHROPLASTY. Grekov's Bulletin of Surgery. 2018;177(1):41-44. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-1-41-44
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