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Factors influencing treatment success of negative pressure wound therapy in patients with postoperative infections after Osteosynthetic fracture fixation

Overview of attention for article published in BMC Musculoskeletal Disorders, June 2017
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Title
Factors influencing treatment success of negative pressure wound therapy in patients with postoperative infections after Osteosynthetic fracture fixation
Published in
BMC Musculoskeletal Disorders, June 2017
DOI 10.1186/s12891-017-1607-0
Pubmed ID
Authors

Kaywan Izadpanah, Stephanie Hansen, Julia Six-Merker, Peter Helwig, Norbert P Südkamp, Hagen Schmal

Abstract

Negative Pressure Wound Therapy (NPWT) is being increasingly used to treat postoperative infections after osteosynthetic fracture fixation. The aim of the present study was to analyze the influence of epidemiological and microbiological parameters on outcome. Infections following operative fracture fixation were registered in a comprehensive Critical Incidence Reporting System and subsequently analyzed retrospectively for characteristics of patients including comorbidity, bacteria, and clinical factors. The influence of the investigated parameters was analyzed using logistic regression models based on data from 106 patients. Staged wound lavage in combination with NPWT allowed implant preservation in 44% and led to successful healing in 73% of patients. Fermentation characteristics, load and behavior after gram staining revealed no statistically significant correlation with either healing or implant preservation. Infecting bacteria were successfully isolated in 87% of patients. 20% of all infections were caused by bacterial combinations. We observed a change in the infecting bacterial species under therapy in 23%. Age, gender, metabolic diseases or comorbidities did not influence the probability of implant preservation or healing. The delayed manifestation of infection (>4 weeks) correlated with a higher risk for implant loss (OR 5.1 [95% CI 1.41-17.92]) as did the presence of bacterial mixture (OR 5.0 [95% CI 1.41-17.92]) and open soft-tissue damage ≥ grade 3 (OR 10.2 [CI 1.88-55.28]). Wounds were less likely to heal in conjunction with high CRP blood levels (>20 mg/l) at the time of discharge (OR 3.6 [95% CI 1.31-10.08]) or following a change of the infecting bacterial species under therapy (OR 3.2 [95% CI, 1.13-8.99]). These results indicate that the delayed manifestation of infection, high CRP blood levels at discharge, and alterations in the infecting bacterial species under therapy raise the risk of NPWT failure.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 30 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 30 100%

Demographic breakdown

Readers by professional status Count As %
Other 6 20%
Student > Master 6 20%
Student > Bachelor 3 10%
Researcher 3 10%
Student > Doctoral Student 2 7%
Other 5 17%
Unknown 5 17%
Readers by discipline Count As %
Medicine and Dentistry 12 40%
Biochemistry, Genetics and Molecular Biology 2 7%
Nursing and Health Professions 2 7%
Psychology 2 7%
Agricultural and Biological Sciences 1 3%
Other 2 7%
Unknown 9 30%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 March 2018.
All research outputs
#12,210,885
of 13,791,430 outputs
Outputs from BMC Musculoskeletal Disorders
#2,504
of 2,733 outputs
Outputs of similar age
#224,107
of 264,087 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#1
of 1 outputs
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