Negative-Pressure Wound Therapy in Acute Traumatic and Surgical Wounds in Orthopaedics

Negative-pressure wound therapy (NPWT) has been widely adopted as one of the primary modalities for treating traumatic wounds and aiding in soft-tissue reconstruction. Despite the abundance of peer-reviewed publications, very few high-level studies exist in the orthopaedic literature. NPWT must be considered as an alternative to traditional skin-graft bolsters, particularly in large, complex wounds with irregular contours or exudation. NPWT should be used as a temporary wound dressing (if primary closure is not possible) between debridements and as coverage for soft-tissue injuries associated with open fractures. Incisional NPWT should be considered as an alternative to conventional dressings in high-risk wounds or patients. Currently, there is inadequate evidence for or against the use of NPWT in combination with antibiotic beads for open fracture management or in cases involving periprosthetic infection or osteomyelitis.