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September 09, 2021
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Negative pressure therapy showed similar wound complication rates as conventional dressing

SAN DIEGO — Use of closed-incision negative pressure therapy had no significant difference in wound complication rates after revision total hip arthroplasty compared with standard conventional dressing, according to preliminary results.

Denis Nam, MD, MSc, and colleagues randomly assigned 113 patients undergoing septic and aseptic revision THA to receive either closed-incision negative pressure therapy (Prevena, Acelity Inc.) or standard conventional dressing (Aquacel, ConvaTec).

“Our primary outcome was the incidence of any wound complications within 90 days of the revision surgery,” Nam, associate professor of orthopedic surgery at Rush University Medical Center, told Healio Orthopedics about results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

Nam noted the preliminary findings of the study showed no significant differences in the rate of wound complications between the two groups.

“There were seven wound complications, or 12%, in the negative pressure group and four wound complications, or 7%, in the Aquacel group, which was not statistically different,” Nam said.

While further investigation is needed before any definitive conclusions can be made, Nam said the approach of the surgery may be affecting the results.

“There have been a lot of revision studies looking at knee replacements and anterior approach hip replacements that have shown negative pressure therapy to be effective,” Nam said. “In our study, based on the way we do our surgeries, almost every single one of our revision surgeries were done via a posterior approach to the hip and it may just be that the posterior approach to the hips is a more forgiving incision than the anterior approach. We do believe that usually posterior approach hips have less incidence of wound complications vs. an anterior approach to the hip, and that likely is one of the reasons why we are not seeing any differences.”