Use of negative-pressure wound therapy in orthopaedic trauma

Philipp N. Streubel, Daniel J. Stinner, William T. Obremskey

Research output: Contribution to journalReview article

41 Scopus citations

Abstract

Negative-pressure wound therapy (NPWT) has become an important adjunct to the management of traumatic wounds and surgical incisions related to musculoskeletal trauma. On the battlefield, this adjunct therapy allows early wound management and safe aeromedical evacuation. NPWT mechanisms of action include stabilization of the wound environment, reduction of wound edema, improvement of tissue perfusion, and stimulation of cells at the wound surface. NPWT stimulates granulation tissue and angiogenesis and may improve the likelihood of primary closure and reduce the need for free tissue transfer. In addition, NPWT reduces the bacterial bioburden of wounds contaminated with gram-negative bacilli. However, an increased risk of colonization of gram-positive cocci (eg, Staphylococcus aureus) exists. Although NPWT facilitates wound management, further research is required to determine conclusively whether this modality is superior to other management options. Ongoing research will continue to define the indications for and benefits of NPWT as well as establish the role of combination therapy, in which NPWT is used with instillation of antibiotic solutions, placement of antibiotic-laden cement beads, or silver-impregnated sponges.

Original languageEnglish (US)
Pages (from-to)564-574
Number of pages11
JournalJournal of the American Academy of Orthopaedic Surgeons
Volume20
Issue number9
DOIs
Publication statusPublished - Sep 1 2012

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ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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