Negative Pressure Incisional Therapy and Postoperative Infection after Posterior Approach Primary Total Hip Arthroplasty

A major complication after total hip arthroplasty (THA) is infection, which can have devastating clinical and financial results. Silver-impregnated dry dressings, such as Aquacel dressings, and incisional negative pressure dressings (Prevena) have been developed to reduce the rates of surgical site infections (SSIs) after surgery. We retrospectively reviewed the medical records of 235 patients who underwent primary posterior approach THA at our institution during a three-year period. Patients were grouped based on surgical dressing. Rates of SSI were recorded, as well as the effects of factors including age, sex, body mass index, and medical comorbidities. In the high-risk subgroup, defined as BMI > 30 and ASA > 3, the infection rate was 2.97% in the Aquacel group, compared to 1.20% in the Prevena group. This difference did not reach statistical significance. There was a statistically significant impact on readmissions rate (p = 0.028) and reoperation (p = 0.001). The findings of this study suggest that negative pressure dressings in carefully selected patients may help to reduce reoperations and readmissions in this subgroup.