Result of negative pressure wound therapy in open fracture

Abstract

Introduction: Open fractures are associated with a high incidence of mainly osteomyelitis. Negative pressure wound therapy (NPWT) is a novel form of treatment that uses sub atmospheric pressure to effect early wound healing. Objectives and study design: To determine the effect of NPWT on incidence of deep infections/ osteomyelitis after open fractures using a prospective randomized study design. Materials and methods: Ninety-five open fractures were randomized into two groups receiving NPWT and the second group undergoing periodic irrigation, cleaning and debridement respectively. The wounds were closed or covered on shrinkage in size and sufficient granulation. Evidence of infection was sought during the course of treatment and follow up. Also, serial cultures were sent every time the wound was cleaned. Results and conclusions: Patients in the control group developed a total of 19 infections (42.21%) as opposed to only 5 (10%) in the NPWT group. FOURTY SEVEN patients developed positive growth when samples were sent for culture with 5 (4.75%) in the NPWT group and 42 (39.9%) in the control group. Only 21 patients (22.2%) went on the develop osteomyelitis, among them 5(10%) patients are in npwt grup and 16(35.55%) are in control group. Thus, negative pressure wound therapy is indeed beneficial for preventing the incidence of both acute infections and osteomyelitis in open fractures. However, a significant difference was seen in the time required for the wound to be ready for delayed primary closure or coverage.