OTA 2007 Posters

Scientific Poster #49 Pelvis OTA-2007

The Effect of Negative Pressure Therapy on Wound Complications after Acetabular Fracture Surgery

Robert N. Reddix, Jr, MD1 (n); Iris Leng, PhD2 (n); Barnaby Dedmond, MD3 (n);
James Woodall, MD4 (n); Ben Jackson, BS2 (n); Brenda Kulp, RN, BSN2 (n);
Lawrence X. Webb, MD2 (n);
1University of North Texas Health Science Center and John Peter Smith Hospital, Fort Worth, Texas, USA;
2Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, USA;
3Lexington Orthopaedics, West Columbia, South Carolina, USA; 4University of Mississippi Medical Center, Jackson, Mississippi, USA

Purpose: The purpose of our study was to determine if the use of incisional negative pressure therapy affected the rate of wound complications after acetabular fracture surgery. We hypothesize that using incisional negative pressure therapy does decrease the rate of wound complications when compared to reported complication rates and to complication rates prior to its use at our own institution.

Methods: A computerized medical record search from 1996 to 2005 of all patients with an operatively treated acetabular fracture yielded 377 patients and 274 patients who were available for a minimum of 3 months for follow-up. We then analyzed those patients who had an incisional vacuum-assisted closure (IVAC) device placed and compared them to those who did not. All surgical approaches and fracture types were included in the analysis. After operative treatment of the patient’s acetabular fracture and a loose layered wound closure, a nonadherent Adaptic dressing was placed over the wound, followed by application of negative pressure therapy at a continuous setting of –75 mm Hg until all wound drainage had ceased. After July 2000, the IVAC became standard postoperative care for all operatively treated acetabular fracture patients. Our main outcomes of interest were wound infections or wound dehiscence.

Results: Patient follow-up ranged from 3 months to 90 months. Information about the presence or absence of postoperative wound complications was gleaned from the medical record. 60 consecutive patients who were available in the 5 years immediately preceding the use of the IVAC had 4 (6.7%) deep wound infections and 2 (3.3%) wound dehiscences. There were 212 patients who had placement of an IVAC, who had 3 (1.4 %) deep wound infections and 1 (0.5%) wound dehiscence. There were no superficial wound infections in the cohort. This difference is significant (P = 0.047).

Conclusions: The use of IVAC significantly decreased perioperative wound complications after acetabular fracture surgery and merits further study.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing.