Int J Med Sci 2009; 6(5):241-246. doi:10.7150/ijms.6.241 This issue Cite

Research Paper

Vacuum-assisted closure in the treatment of early hip joint infections

Jens Kelm1,2, Eduard Schmitt1, Konstantinos Anagnostakos1 ✉

1. Department of Orthopaedic Surgery, University Hospital, Saarland University, Homburg/Saar, Germany
2. Chirurgisch-Orthopädisches Zentrum Illingen/Saar, Germany

Citation:
Kelm J, Schmitt E, Anagnostakos K. Vacuum-assisted closure in the treatment of early hip joint infections. Int J Med Sci 2009; 6(5):241-246. doi:10.7150/ijms.6.241. https://www.medsci.org/v06p0241.htm
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Abstract

The aim of the present study was to evaluate the efficacy of the vacuum-assisted closure (V.A.C.) system in the treatment of early hip joint infections. 28 patients (11 m / 17 f; mean age 71 y. [43-84]) with early hip joint infections have been treated by means of the V.A.C.-therapy. At least one surgical revision [1-7] has been unsuccessfully performed for infection treatment prior to V.A.C. - application. Pathogen organisms could have been isolated in 22/28 wounds. During revision, cup inlay and prosthesis head have been exchanged and 1-3 polyvinylalcohol sponges inserted into the wound cavity/ periprosthetically at an initial continuous pressure of 200 mm Hg. Postoperatively, a systemic antibiosis was given according to antibiogram. 48-72 h after surgery an alteration from haemorrhagic to serous fluid was observed in the V.A.C.-canister. Afterwards, the pressure was decreased to 150 mm Hg and remained at this level till sponge removal. After a mean period of 9 [3-16] days the inflammation parameters have been retrogressive and the sponges were removed. An infection eradication could be achieved in 26/28 cases. In the two remaining cases the infected prosthesis had to be explanted and a gentamicin-vancomycin-loaded spacer has been implanted, respectively. At a total mean follow-up of 36 [12-87] months no reinfection or infection persistence was observed. The V.A.C.-system can be a valuable contribution in the treatment of early joint infections when properly used. Indications should be early infections with well-maintained soft-tissues for retention of the negative atmospheric pressure.

Keywords: vacuum-assisted closure, V.A.C.-therapy, early infection, hip joint


Citation styles

APA
Kelm, J., Schmitt, E., Anagnostakos, K. (2009). Vacuum-assisted closure in the treatment of early hip joint infections. International Journal of Medical Sciences, 6(5), 241-246. https://doi.org/10.7150/ijms.6.241.

ACS
Kelm, J.; Schmitt, E.; Anagnostakos, K. Vacuum-assisted closure in the treatment of early hip joint infections. Int. J. Med. Sci. 2009, 6 (5), 241-246. DOI: 10.7150/ijms.6.241.

NLM
Kelm J, Schmitt E, Anagnostakos K. Vacuum-assisted closure in the treatment of early hip joint infections. Int J Med Sci 2009; 6(5):241-246. doi:10.7150/ijms.6.241. https://www.medsci.org/v06p0241.htm

CSE
Kelm J, Schmitt E, Anagnostakos K. 2009. Vacuum-assisted closure in the treatment of early hip joint infections. Int J Med Sci. 6(5):241-246.

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