The Effectiveness of Closed Incision Negative Pressure Thera
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The present study aimed to evaluate the efficacy of closed incision negative pressure therapy(ciNPT) vs. silver-impregnated antimicrobial dressing (AMD) in mitigating postoperative surgical site complications(SSC); the effect of ciNPT vs. AMD on certain postoperative health utilization parameters; and on patient-reported outcomes(PRO) improvement at 90-day postoperative follow-up.

In this multicenter randomized controlled trial patients m22 years, at high-risk for SSC, and receiving rTKA with full exchange and reimplantation of new prosthetic components or open reduction and internal fixation of periprosthetic fractures were screened for inclusion. Eligible patients were randomized to receive a commercially-available ciNPT system or a silver-impregnated AMD (n=147, each) for minimum of 5-days duration. Primary outcome was the 90-day incidence of SSCs with stratification according to revision type(aseptic/septic). Secondary outcomes were the 90-day health care utilization parameters(readmission, reoperation, dressing changes, and visits), and PROs.

--Of 294 patients randomized(age:64.9±9.0, female:59.6%), 242 patients completed the study(ciNPT:n=124; AMD:n=118).

--The incidence of 90-day SSCs was lower for the ciNPT cohort(ciNPT:3.4% vs. AMD:14.3%; odds ratio (OR):0.22). Readmission rates(3.4% vs. 10.2%, OR:0.30) and mean dressing changes (1.1±0.3 vs. 1.3±1.0) were lower with ciNPT.

--The differences in reoperation rates, number of visits, and PRO improvement between both arms were not statistically significant.

Conclusively, after rTKA, ciNPT is successful in reducing 90-day SSCs, readmission, and the number of dressing changes.