Negative pressure wound therapy may increase deep infection rate
DENVER — Patients managed with negative pressure wound therapy for severe open fracture wounds experienced lower physical quality of life scores and higher odds of developing deep infections that required operative management compared with patients who did not have the therapy, according to results presented at the Orthopaedic Trauma Association Annual Meeting.
Using the Fluid Lavage of Open Wounds Trial database, Yousif Atwan, MD, and colleagues matched patients with severe open fracture wounds treated with and without negative pressure wound therapy based on Gustilo type, irrigation solution, mechanism of injury and degree of contamination. Atwan noted the main variable of interest was the rate of deep infection that required a reoperation within 12 months.
“For our second part of the study, we took a look at health-related quality of life outcomes and our main measure was the SF-12, looking at both physical and mental component scores,” Atwan said in his presentation here.
Among the 246 matched pairs of patients available for comparison, Atwan noted use of negative pressure wound therapy yielded a higher infection rate.
“Those who used negative pressure wound therapy had just over three-fold increased odds of developing a deep infection that required a reoperation within 12 months,” he said.
After performing a sensitivity analysis in which patients with severe injuries were excluded, Atwan said use of negative pressure wound therapy resulted in two-fold increased odds of deep infection. He added patients who did not receive negative pressure wound therapy had higher SF-12 physical component scores at 6 weeks.
“When it comes to the mental component scores, there was only a significant difference at the 6-week mark, where those with no negative pressure wound therapy had slightly higher scores,” Atwan said. – by Casey Tingle
Atwan Y, et al. Abstract 70. Presented at: Orthopaedic Trauma Association Annual Meeting; Sept. 25-28, 2019; Denver.
Disclosure: Atwan reports no relevant financial disclosures.