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Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons
Background: Persistent wound leakage after joint arthroplasty is a scantily investigated topic, despite the claimed relation with a higher risk of periprosthetic joint infection. This results in a lack of evidence-based clinical guidelines for the diagnosis and treatment of persistent wound leakage...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ivyspring International Publisher
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704001/ https://www.ncbi.nlm.nih.gov/pubmed/29188171 http://dx.doi.org/10.7150/jbji.22327 |
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author | Wagenaar, Frank-Christiaan Löwik, Claudia A.M. Stevens, Martin Bulstra, Sjoerd K. Pronk, Yvette van den Akker-Scheek, Inge Wouthuyzen-Bakker, Marjan Nelissen, Rob G.H.H. Poolman, Rudolf W. van der Weegen, Walter Jutte, Paul C. |
author_facet | Wagenaar, Frank-Christiaan Löwik, Claudia A.M. Stevens, Martin Bulstra, Sjoerd K. Pronk, Yvette van den Akker-Scheek, Inge Wouthuyzen-Bakker, Marjan Nelissen, Rob G.H.H. Poolman, Rudolf W. van der Weegen, Walter Jutte, Paul C. |
author_sort | Wagenaar, Frank-Christiaan |
collection | PubMed |
description | Background: Persistent wound leakage after joint arthroplasty is a scantily investigated topic, despite the claimed relation with a higher risk of periprosthetic joint infection. This results in a lack of evidence-based clinical guidelines for the diagnosis and treatment of persistent wound leakage after joint arthroplasty. Without such guideline, clinical practice in orthopaedic hospitals varies widely. In preparation of a nationwide multicenter randomized controlled trial on the optimal treatment of persistent wound leakage, we evaluated current Dutch orthopaedic care for persistent wound leakage after joint arthroplasty. Methods: We conducted a questionnaire-based online survey among all 700 members of the Netherlands Orthopaedic Association, consisting of 23 questions on the definition, classification, diagnosis and treatment of persistent wound leakage after joint arthroplasty. Results: The questionnaire was completed by 127 respondents, representing 68% of the Dutch hospitals that perform orthopaedic surgery. The results showed wide variation in the classification, definition, diagnosis and treatment of persistent wound leakage among Dutch orthopaedic surgeons. 56.7% of the respondents used a protocol for diagnosis and treatment of persistent wound leakage, but only 26.8% utilized the protocol in every patient. Most respondents (59.1%) reported a maximum period of persistent wound leakage before starting non-surgical treatment of 3 to 7 days after index surgery and 44.1% of respondents reported a maximum period of wound leakage of 10 days before converting to surgical treatment. Conclusions: The wide variety in clinical practice underscores the importance of developing an evidence-based clinical guideline for the diagnosis and treatment of persistent wound leakage after joint arthroplasty. To this end, a nationwide multicenter randomized controlled trial will be conducted in the Netherlands, which may provide evidence on this important and poorly understood topic. |
format | Online Article Text |
id | pubmed-5704001 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Ivyspring International Publisher |
record_format | MEDLINE/PubMed |
spelling | pubmed-57040012017-11-29 Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons Wagenaar, Frank-Christiaan Löwik, Claudia A.M. Stevens, Martin Bulstra, Sjoerd K. Pronk, Yvette van den Akker-Scheek, Inge Wouthuyzen-Bakker, Marjan Nelissen, Rob G.H.H. Poolman, Rudolf W. van der Weegen, Walter Jutte, Paul C. J Bone Jt Infect Research Paper Background: Persistent wound leakage after joint arthroplasty is a scantily investigated topic, despite the claimed relation with a higher risk of periprosthetic joint infection. This results in a lack of evidence-based clinical guidelines for the diagnosis and treatment of persistent wound leakage after joint arthroplasty. Without such guideline, clinical practice in orthopaedic hospitals varies widely. In preparation of a nationwide multicenter randomized controlled trial on the optimal treatment of persistent wound leakage, we evaluated current Dutch orthopaedic care for persistent wound leakage after joint arthroplasty. Methods: We conducted a questionnaire-based online survey among all 700 members of the Netherlands Orthopaedic Association, consisting of 23 questions on the definition, classification, diagnosis and treatment of persistent wound leakage after joint arthroplasty. Results: The questionnaire was completed by 127 respondents, representing 68% of the Dutch hospitals that perform orthopaedic surgery. The results showed wide variation in the classification, definition, diagnosis and treatment of persistent wound leakage among Dutch orthopaedic surgeons. 56.7% of the respondents used a protocol for diagnosis and treatment of persistent wound leakage, but only 26.8% utilized the protocol in every patient. Most respondents (59.1%) reported a maximum period of persistent wound leakage before starting non-surgical treatment of 3 to 7 days after index surgery and 44.1% of respondents reported a maximum period of wound leakage of 10 days before converting to surgical treatment. Conclusions: The wide variety in clinical practice underscores the importance of developing an evidence-based clinical guideline for the diagnosis and treatment of persistent wound leakage after joint arthroplasty. To this end, a nationwide multicenter randomized controlled trial will be conducted in the Netherlands, which may provide evidence on this important and poorly understood topic. Ivyspring International Publisher 2017-11-03 /pmc/articles/PMC5704001/ /pubmed/29188171 http://dx.doi.org/10.7150/jbji.22327 Text en © Ivyspring International Publisher This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions. |
spellingShingle | Research Paper Wagenaar, Frank-Christiaan Löwik, Claudia A.M. Stevens, Martin Bulstra, Sjoerd K. Pronk, Yvette van den Akker-Scheek, Inge Wouthuyzen-Bakker, Marjan Nelissen, Rob G.H.H. Poolman, Rudolf W. van der Weegen, Walter Jutte, Paul C. Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title | Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title_full | Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title_fullStr | Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title_full_unstemmed | Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title_short | Managing persistent wound leakage after total knee and hip arthroplasty. Results of a nationwide survey among Dutch orthopaedic surgeons |
title_sort | managing persistent wound leakage after total knee and hip arthroplasty. results of a nationwide survey among dutch orthopaedic surgeons |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5704001/ https://www.ncbi.nlm.nih.gov/pubmed/29188171 http://dx.doi.org/10.7150/jbji.22327 |
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