M Lüdemann1, S Haid, N Wülker, M Rudert. 1. Orthopädische Universitätsklinik, Universitätsklinikum Tübingen, Germany. martin.luedemann@med.uni-tuebingen.de
Abstract
AIM: At present the vacuum sealing technique is acknowledged as a therapy for acute and chronic wounds. An acceleration of the healing process, due to the vacuum suction with occlusive wound dressing, leads to the shortening of a cost-effective medical treatment. This can be applied to wound treatment and infections of soft tissues, but even today there is only sparse information in this context about joint infections. METHOD: The results of therapy with the vacuum sealing technique in 68 patients with infections of the joints of an extremity or the trunk were analysed in a retrospective study without a control group. The importance of several patient-related factors for the medical treatment have been analysed. RESULTS: An adequate treatment of joint infections can be achieved even in the presence of endoprostheses or osteosynthetic material. The following factors have been found to be of significance for a prolonged medical treatment: diabetes mellitus (p=0.0052), obesity (BMI>25) (p=0.0458) and a preceding trauma (p=0.0457). CONCLUSION: The results confirm the value of the vacuum sealing technique following surgical debridement in combination with resistance tested antibiotic treatment, as a sufficient therapy for joint infections, even in patients with an endoprosthesis. This procedure leads to a safe treatment of the joint infection, combined with a good function of the treated joint, good patient comfort and a short duration of the therapy.
AIM: At present the vacuum sealing technique is acknowledged as a therapy for acute and chronic wounds. An acceleration of the healing process, due to the vacuum suction with occlusive wound dressing, leads to the shortening of a cost-effective medical treatment. This can be applied to wound treatment and infections of soft tissues, but even today there is only sparse information in this context about joint infections. METHOD: The results of therapy with the vacuum sealing technique in 68 patients with infections of the joints of an extremity or the trunk were analysed in a retrospective study without a control group. The importance of several patient-related factors for the medical treatment have been analysed. RESULTS: An adequate treatment of joint infections can be achieved even in the presence of endoprostheses or osteosynthetic material. The following factors have been found to be of significance for a prolonged medical treatment: diabetes mellitus (p=0.0052), obesity (BMI>25) (p=0.0458) and a preceding trauma (p=0.0457). CONCLUSION: The results confirm the value of the vacuum sealing technique following surgical debridement in combination with resistance tested antibiotic treatment, as a sufficient therapy for joint infections, even in patients with an endoprosthesis. This procedure leads to a safe treatment of the joint infection, combined with a good function of the treated joint, good patient comfort and a short duration of the therapy.
Authors: Maximilian Rudert; Cornelia Winkler; Boris Michael Holzapfel; Hans Rechl; Peter Kneschaurek; Reiner Gradinger; Michael Molls; Barbara Röper Journal: Strahlenther Onkol Date: 2010-03-26 Impact factor: 3.621