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    TECH SHOWCASE: A Role for Negative Pressure Wound Therapy

    Editor’s Note: A session at ICJR’s 13th Annual Winter Hip & Knee Course was billed as a Technology Showcase, featuring 8 presentations on aspects of technology and techniques intended to help surgeons improve outcomes of hip and knee arthroplasty. We are highlighting those presentations on ICJR.net this week.

    When R. Michael Meneghini, MD, and his colleagues developed evidence-based protocols for reducing the risk of complications in high-risk total joint arthroplasty patients – those who have co-morbidities such as diabetes, obesity, renal disease, autoimmune disease, and peripheral vascular disease – it became apparent that wound management would play an important role.

    Speaking at ICJR’s 13th Annual Winter Hip & Knee Course, Dr. Meneghini noted how much wound treatment has evolved since he began practice more than 15 years ago, moving from staples, vertical mattress sutures, and ABD dressings to running subcutaneous sutures, skin sealant, and silver-impregnated occlusive dressings.

    But even with these advances – and despite the protocols they put into place – Dr. Meneghini and his colleagues were seeing wound complications with their high-risk patients. So, they began to investigate a technology intended to help heal difficult surgical wounds: closed incisional negative pressure wound therapy (ciNPWT).

    After seeing a reduction in incisional wound complications in their high-risk patients, [1] Dr. Meneghini and his colleagues now use ciNPWT with:

    • All high-risk primary total joint arthroplasty patients as prophylactic incisional treatment
    • Patients with postoperative drainage from a sterile hematoma
    • Complex total joint arthroplasty revisions and patients with periprosthetic joint infections

    Routine, lower-risk primary total joint arthroplasty patients are not candidates for ciNPWT, Dr. Meneghini said, because they don’t need it. They do well with standard wound care that includes silver-impregnated occlusive dressings.

    Click the image above to watch Dr. Meneghini’s presentation and learn more about the mechanism of action for ciNPWT, supporting data, and application tips and tricks.

    Faculty Bio

    R. Michael Meneghini, MD, is a Professor of Clinical Orthopaedic Surgery at Indiana University School of Medicine, Fishers, Indiana. He is also Director of the IU Hip & Knee Center.

    Disclosures: Dr. Meneghini has disclosed that he receives royalties from and is a paid consultant for DJO and OsteoRemedies; that he has stock or stock options in Emovi; that he is a paid consultant for 3M+KCI, Kinamed, and Surgical Care Affiliates; and that he had ownership shares in the IU Health Saxony ambulatory surgery center.

    Reference

    1. Doman DM, Young AM, Buller LT, Deckard ER, Meneghini RM. Comparison of surgical site complications with negative pressure wound therapy vs silver impregnated dressing in high-risk total knee arthroplasty patients: a matched cohort study. J Arthroplasty . 2021 May 24;S0883-5403(21)00512-X. doi: 10.1016/j.arth.2021.05.030. Online ahead of print.