Negative pressure wound therapy for flap closed-incisions after 3D-printed prosthesis implantation in patients with chronic osteomyelitis with soft tissue defects

• Published in: BMC musculoskeletal disorders 2023-10, Vol.24 (1), p.1-827, Article 827
• Main Authors: Lin, Zhiyu, Zhang, Xinling, Chen, Yujie, Tian, Yun, Yang, Xin, Zhao, Zhenmin
• Format: Article
• Language: English
• Subjects: Antibiotics; Asepsis; Bacterial infections; Care and treatment; Chronic osteomyelitis; Closed-incision; Complications; Debridement; Defects; Dehiscence; Health aspects; Hospital costs; Implants, Artificial; Infections; Medical records; Medical research; Medicine, Experimental; Musculoskeletal diseases; Negative pressure wound therapy; Normal distribution; Osteomyelitis; Patients; Polymethyl methacrylate; Postoperative; Prostheses; Prosthesis; Soft tissue defects; Transplants & implants; Wound healing; Wounds
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06970-1

Background The flap closed-incisions healing after 3D-printed prosthesis implantation in Chronic Osteomyelitis with Soft Tissue Defects (COSTD) is critical. This study aimed to explore the safety and effectiveness of Negative Pressure Wound Therapy (NPWT) in promoting flap closed-incisions healing. Methods Retrospective analysis of clinical data was performed, including baseline, surgical and hospitalization information. The efficacy of NPWT was assessed by comparing the ASEPSIS scores, Visual Analogue Scale (VAS), Activity of Daily Living Scale (ADLS), and Lower Extremity Functional Scale (LEFS), as well as the major postoperative complications. Results The study included 20 patients, 13 received conventional dressing (Control group) and 7 received NPWT treatment (NPWT group). These two groups exhibited a notable disparity in the distribution of ASEPSIS scores, and the median scores were 24 in Control group and 9 in NPWT group (p = 0.001). Eight patients in the Control group experienced major incisional complications, including 7 cases of exudation, 3 cases of infection, 2 cases of non-healing, and 1 case of dehiscence, while none were observed in the NPWT group (p = 0.015). The VAS, ADLS, and LEFS scores were significantly improved in the NPWT group compared to the Control group (p = 0.003, 0.017, and 0.043, respectively). Conclusions The study findings suggest that NPWT applied to the healing process of flap closed-incisions after 3D prosthesis implantation in patients with COSTD can reduce the occurrence of postoperative major complications and promote the recovery of lower limb function and daily activities, which should be recommended for clinical practice. Keywords: Chronic osteomyelitis, Closed-incision, Negative pressure wound therapy, Soft tissue defects