Abstract

To determine if incisional negative pressure wound therapy is protective against post-operative surgical site complications following definitive fixation of bicondylar tibial plateau fractures.A retrospective analysis of patients diagnosed with an acute bicondylar tibial plateau fracture (AO/OTA 41-C) undergoing ORIF from 2010 to 2020 was performed. Patients received either a standard sterile dressing (SD) or incisional negative pressure wound therapy (iNPWT). Primary outcomes included surgical site infection, osteomyelitis, and wound dehiscence. Secondary outcomes included non-union and return to the operating room. Multivariate logistic regression analyses were performed.180 patients were included and 22% received iNPWT (n?=?40) and 78% received standard dressings (n?=?140). iNPWT was more common in active smokers (24.7% vs. 19.3%, p?=?0.002) and the SD group was more likely to be lost to follow up (3.6% vs. 0%, p?=?0.025). iNPWT was not protective against infection or surgical site complications, and in fact, was associated with higher odds of post-operative infection (OR: 8.96, p?=?0.005) and surgical site complications (OR:4.874, p?=?0.009) overall. Alcohol abuse (OR: 19, p?=?0.005), tobacco use (OR: 4.67, p?=?0.009), and time to definitive surgery (OR?=?1.21, p?=?0.033) were all independent risk factors for post-operative infection.In this series of operatively treated bicondylar tibial plateau fractures, iNPWT did not protect against post-operative surgical site complications compared to conventional dressings. Tobacco use, alcohol abuse, and time to definitive surgery, were independent risk factors for post-operative infection. Further studies are needed to determine if iNPWT offers a protective benefit in exclusively high-risk patients with relevant medical and social history.

View details for DOI 10.1007/s00590-023-03782-w

View details for PubMedID 37989870