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

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

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Vacuum Fan Motor Unit 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 mens-clothing infections with well-maintained soft-tissues for retention of the negative atmospheric pressure.