Using Negative Pressure Wound Therapy With Intramedullary and Subcutaneous Antibiotic Perfusion
Keisuke Shimbo, Tatsuhiko Saiki, Haruka Kawamoto, Isao Koshima
Surgical site infection (SSI) after fracture fixation is associated with higher-grade Gustilo-Anderson open fractures (ie, type III).1,2 Patients with SSI that has progressed to deep infection or osteomyelitis must undergo multiple surgeries and may experience permanent dysfunction at the fracture site. Radical surgical debridement, orthopedic implant removal, and systemic antibiotic administration are generally performed to control SSIs. Orthopedic implant removal is considered to be an efficacious procedure. For example, 28% to 79% of orthopedic implants are removed after foot, ankle, or lower leg fracture surgery.3,4 After orthopedic implant removal, postoperative SSI rates are reportedly 0% to 20%.3-5 The standard-of-care therapeutic regimen is insufficient in the management of SSI after fracture fixation. Some studies have reported the use of negative pressure wound therapy … read more