International Orthopaedics

, Volume 36, Issue 4, pp 719–722 | Cite as

Negative pressure wound therapy to prevent seromas and treat surgical incisions after total hip arthroplasty

  • Milena Pachowsky
  • Johannes Gusinde
  • Andrea Klein
  • Siegfried Lehrl
  • Stefan Schulz-Drost
  • Philipp Schlechtweg
  • Johannes Pauser
  • Kolja Gelse
  • Matthias H. BremEmail author
Original Paper



The purpose of this study was to evaluate the use of negative pressure wound therapy (NPWT) to improve wound healing after total hip arthroplasty (THA) and its influence on the development of postoperative seromas in the wound area.


The study is a prospective randomised evaluation of NPWT in patients with large surgical wounds after THA, randomising patients to either a standard dressing (group A) or a NPWT (group B) over the wound area. The wound area was examined with ultrasound to measure the postoperative seromas in both groups on the fifth and tenth postoperative days.


There were 19 patients randomised in this study. Ten days after surgery, group A (ten patients, 70.5 ± 11.01 years of age) developed seromas with an average size of 5.08 ml and group B (nine patients, 66.22 ± 17.83 years of age) 1.97 ml. The difference was significant (p = 0.021).


NPWT has been used on many different types of traumatic and non traumatic wounds. This prospective, randomised study has demonstrated decreased development of postoperative seromas in the wound and improved wound healing.


Closed Wound Wound Area Negative Pressure Wound Treatment Improve Wound Healing Total Ankle Replacement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Matthias H. Brem gave scientific presentations for KCI. The PREVENATM wound treatment system was provided by KCI free of charge.


  1. 1.
    Kanakaris NK, Thanasas C, Keramaris N, Kontakis G, Granick MS, Giannoudis PV (2007) The efficacy of negative pressure wound therapy in the management of lower extremity trauma: review of clinical evidence. Injury 38(Suppl 5):S9–S18. doi: 10.1016/j.injury.2007.10.029 PubMedGoogle Scholar
  2. 2.
    Runkel N, Krug E, Berg L, Lee C, Hudson D, Birke-Sorensen H, Depoorter M, Dunn R, Jeffery S, Duteille F, Bruhin A, Caravaggi C, Chariker M, Dowsett C, Ferreira F, Martinez JM, Grudzien G, Ichioka S, Ingemansson R, Malmsjo M, Rome P, Vig S, Martin R, Smith J (2011) Evidence-based recommendations for the use of negative pressure wound therapy in traumatic wounds and reconstructive surgery: steps towards an international consensus. Injury 42 Suppl 1:S1–12. doi: 10.1016/S0020-1383(11)00041-6 Google Scholar
  3. 3.
    Lehner B, Fleischmann W, Becker R, Jukema GN (2011) First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study. Int Orthop. doi: 10.1007/s00264-011-1274-y
  4. 4.
    Stannard JP, Singanamala N, Volgas DA (2010) Fix and flap in the era of vacuum suction devices: what do we know in terms of evidence based medicine? Injury 41(8):780–786. doi: 10.1016/j.injury.2009.08.011
  5. 5.
    Stannard JP, Robinson JT, Anderson ER, McGwin G Jr, Volgas DA, Alonso JE (2006) Negative pressure wound therapy to treat hematomas and surgical incisions following high-energy trauma. J Trauma 60(6):1301–1306. doi: 10.1097/01.ta.0000195996.73186.2e PubMedCrossRefGoogle Scholar
  6. 6.
    DeCarbo WT, Hyer CF (2010) Negative-pressure wound therapy applied to high-risk surgical incisions. J Foot Ankle Surg 49 (3):299–300. doi: 10.1053/j.jfas.2010.01.002 Google Scholar
  7. 7.
    DeFranzo AJ, Argenta LC, Marks MW, Molnar JA, David LR, Webb LX, Ward WG, Teasdall RG (2001) The use of vacuum-assisted closure therapy for the treatment of lower-extremity wounds with exposed bone. Plast Reconstr Surg 108(5):1184–1191PubMedCrossRefGoogle Scholar
  8. 8.
    Fleischmann W, Russ M, Marquardt C (1996) Closure of defect wounds by combined vacuum sealing with instrumental skin expansion. Unfallchirurg 99(12):970–974PubMedCrossRefGoogle Scholar
  9. 9.
    Horch RE, Münchow S, Dragu A (2011) Erste Zwischenergebnisse der Perfusionsbeeinflussung durch Prevena: Gewebsperfusion. Z Wundheilung A 16:19–20Google Scholar
  10. 10.
    Dedmond BT, Kortesis B, Punger K, Simpson J, Argenta J, Kulp B, Morykwas M, Webb LX (2007) The use of negative-pressure wound therapy (NPWT) in the temporary treatment of soft-tissue injuries associated with high-energy open tibial shaft fractures. J Orthop Trauma 21(1):11–17. doi: 10.1097/BOT.0b013e31802cbc54 PubMedCrossRefGoogle Scholar
  11. 11.
    Lehner B, Bernd L (2006) V.A.C.-instill therapy in periprosthetic infection of hip and knee arthroplasty. Zentralbl Chir 131(Suppl 1):S160–S164. doi: 10.1055/s-2006-921513 PubMedCrossRefGoogle Scholar
  12. 12.
    Brem MH, Blanke M, Olk A, Schmidt J, Mueller O, Hennig FF, Gusinde J (2008) The vacuum-assisted closure (V.A.C.) and instillation dressing: limb salvage after 3 degrees open fracture with massive bone and soft tissue defect and superinfection. Unfallchirurg 111(2):122–125. doi: 10.1007/s00113-007-1360-1 PubMedCrossRefGoogle Scholar
  13. 13.
    Gesslein M, Horch RE (2006) Interdisciplinary management of complex chronic ulcers using vacuum assisted closure therapy and "buried chip skin grafts". Zentralbl Chir 131(Suppl 1):S170–S173. doi: 10.1055/s-2006-921460 PubMedCrossRefGoogle Scholar
  14. 14.
    Loos B, Kopp J, Kneser U, Weyand M, Horch RE (2006) The importance of vacuum therapy in the treatment of sternal osteomyelitis from the plastic surgeons point of view. Zentralbl Chir 131(Suppl 1):S124–S128. doi: 10.1055/s-2006-921425 PubMedCrossRefGoogle Scholar
  15. 15.
    Stannard JP, Volgas DA, Stewart R, McGwin G Jr, Alonso JE (2009) Negative pressure wound therapy after severe open fractures: a prospective randomized study. J Orthop Trauma 23(8):552–557. doi: 10.1097/BOT.0b013e3181a2e2b6 PubMedCrossRefGoogle Scholar
  16. 16.
    Fleischmann W, Strecker W, Bombelli M, Kinzl L (1993) Vacuum sealing as treatment of soft tissue damage in open fractures. Unfallchirurg 96(9):488–492PubMedGoogle Scholar
  17. 17.
    Horch RE, Gerngross H, Lang W, Mauckner P, Nord D, Peter RU, Vogt PM, Wetzel-Roth W, Willy C (2005) Indications and safety aspects of vacuum-assisted wound closure. MMW Fortschr Med 147(Suppl 1):1–5PubMedGoogle Scholar
  18. 18.
    Willy C, von Thun-Hohenstein H, von Lubken F, Weymouth M, Kossmann T, Engelhardt M (2006) Experimental principles of the V.A.C.-therapy—pressure values in superficial soft tissue and the applied foam. Zentralbl Chir 131(Suppl 1):S50–S61. doi: 10.1055/s-2006-921421 PubMedCrossRefGoogle Scholar
  19. 19.
    Stannard JP, Atkins BZ, O'Malley D, Singh H, Bernstein B, Fahey M, Masden D, Attinger CE (2009) Use of negative pressure therapy on closed surgical incisions: a case series. Ostomy Wound Manage 55(8):58–66PubMedGoogle Scholar
  20. 20.
    Kaplan M, Daly D, Stemkowski S (2009) Early intervention of negative pressure wound therapy using vacuum-assisted closure in trauma patients: impact on hospital length of stay and cost. Adv Skin Wound Care 22(3):128–132. doi: 10.1097/01.ASW.0000305451.71811.d5 PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Milena Pachowsky
    • 1
  • Johannes Gusinde
    • 1
  • Andrea Klein
    • 1
  • Siegfried Lehrl
    • 2
  • Stefan Schulz-Drost
    • 1
  • Philipp Schlechtweg
    • 3
  • Johannes Pauser
    • 4
  • Kolja Gelse
    • 1
  • Matthias H. Brem
    • 1
    Email author
  1. 1.Department of Surgery, Division of Trauma Surgery and Orthopaedic SurgeryFriedrich-Alexander University Erlangen-NurembergErlangenGermany
  2. 2.Department of Psychiatry and PsychotherapyFriedrich-Alexander University Erlangen-NurembergErlangenGermany
  3. 3.Department of RadiologyFriedrich-Alexander University Erlangen-NurembergErlangenGermany
  4. 4.Department of Orthopaedic RhumatologyFriedrich-Alexander University Erlangen-NurembergErlangenGermany

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