[Clinical evolution of patients with infection associated with orthopedic devices in treatment with continuous negative pressure].

Abstract

Objective: To describe the use of negative pressure therapy with (TPNi) and without instillation (TPNs) as adjuvant treatment in the management of orthopedic device-associated infections (IADO).

Method: Analytic observational study of records of patients with IADO managed with TPNi and TPNs with 0.9% saline solution, in patients > 18 years, operated on in 2018-2021. Clinical characteristics of infection, infectious agent as well as sociodemographic variables were evaluated. TPN was performed with the V.A.C. VERAFLO™ system. Analysis with χ2, Fisher and t-Student. Statistically accepted value p < 0.05.

Results: Sample 40 patients. 75% male. Fractures 42.5% exposed and 57.5% closed. 92.5% applied prophylactic antibiotic (30-120 min). 35% plate implants, 12.5% centromedullary nail, 10% knee prosthesis and 12.5% hip. 47.5% bleeding < 500 ml. 72.5% surgical time of 2-4 hours. Previous hospitalization time, TPNs 3 weeks 55.9% and 4 weeks 26.5%; TPNi, 3 weeks 50% and 4 weeks 33.3%. Conservation of the implant 73.5% TPNs and 50% TPNi (p = 0.341). Wound closure 91.2% with TPNs and 100% with TPNi (p = 1.000).

Conclusions: The use of TPNs and TPNi were useful as adjuvant treatments in the management of IADO, in addition they allowed to preserve the implant and wound closure in a large part of the patients.