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International Journal of Medical Sciences

.: Home > International Journal of Medical Sciences > 2009 > Volume 6 Number 5 > Jens Kelm 1,2, Eduard Schmitt 1, Konstantinos Anagnostakos 1

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

Jens Kelm 1,2, Eduard Schmitt 1, Konstantinos Anagnostakos 1
1. Department of Orthopaedic Surgery, University Hospital, Saarland University, Homburg/Saar, Germany 2. Chirurgisch-Orthopنdisches Zentrum Illingen/Saar, Germany
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

Date Deposited : 28 Jul 2011 09:52

Last Modified : 28 Jul 2011 09:52

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Volume 6, Number 5, - 2009 , ISSN 1449-1907

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