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A Frodl Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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N Geisteuer Department of Orthopedics and Traumatology, Asklepios Hospital Harburg, Hamburg, Germany

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A Fuchs Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany

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T Nymark Department of Orthopedic Surgery, University Hospital Odense, Odense C, Denmark

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H Schmal Department of Orthopedics and Traumatology, Freiburg University Hospital, Freiburg, Germany
Department of Orthopedic Surgery, University Hospital Odense, Odense C, Denmark

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combination of impaired blood supply and hyperglycemic states further increases the risk of surgical-site infections ( 3 , 4 ). In such cases, as reported by Willy et al. , closed-incisional negative pressure wound therapy (iNPWT) has shown clinical

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Önder İ. Kılıçoğlu Department of Orthopaedics and Traumatology, İstanbul University, Istanbul Faculty of Medicine, Turkey

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Mehmet Demirel Department of Orthopaedics and Traumatology, İstanbul University, Istanbul Faculty of Medicine, Turkey

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Şamil Aktaş Department of Underwater and Hyperbaric Medicine, İstanbul University, Istanbul Faculty of Medicine, Turkey

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for HBOT as an adjunctive treatment for DFUs. 51 Negative pressure wound therapy (NPWT) NPWT, also called vacuum-assisted closure, has been cited as one of the most effective current strategies in reducing the risk of amputation and

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Richard Peter Almeida Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

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Lipalo Mokete Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

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Nkhodiseni Sikhauli Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

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Allan Roy Sekeitto Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

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Jurek Pietrzak Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa

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-microbial action has shown some benefit. 19 Negative pressure wound therapy (NPWT) has been reported to decrease wound complications such as haematoma, seroma, dehiscence and infection. 66 , 67 NPWT reduces local tissue oedema, prevents deformation of the

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Elena Gálvez-Sirvent Department of Orthopaedic Surgery, “Infanta Elena” University Hospital, Valdemoro, Madrid, Spain
Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain

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Aitor Ibarzábal-Gil Department of Orthopaedic Surgery, “La Paz” University Hospital, Madrid, Spain

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E Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, “La Paz” University Hospital, Madrid, Spain
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain

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microbiological concepts . Injury 2018 49 511 – 522 . ( https://doi.org/10.1016/j.injury.2016.09.019 ) 63. Blum ML Esser M Richardson M Paul E Rosenfeldt FL . Negative pressure wound therapy reduces deep infection rate in open tibial fractures

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Abdel Rahim Elniel Leeds Teaching Hospitals Trust, UK

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Peter V. Giannoudis Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals, University of Leeds, UK; NIHR Leeds Biomedical Research Unit, Chapel Allerton Hospital, UK

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. The patient underwent, nine months previously, exchange nailing to attempt further stimulation of the healing response. Negative pressure wound therapy has been described as a feasible adjunct in managing Gustilo III-B tibial fractures. 40

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Andreas F. Mavrogenis First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Panayiotis D. Megaloikonomos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Thekla Antoniadou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Vasilios G. Igoumenou First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Georgios N. Panagopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Leonidas Dimopoulos First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Konstantinos G. Moulakakis Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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George S. Sfyroeras Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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Andreas Lazaris Department of Vascular Surgery, National and Kapodistrian University of Athens, School of Medicine, ATTIKON University Hospital, Athens, Greece

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N . Negative pressure wound therapy for treating foot wounds in people with diabetes mellitus . Cochrane Database Syst Rev 2013 ;( 10 ):CD010318. 64. Driver VR Blume PA . Evaluation of wound care and health

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Petra Izakovicova HELIOS Klinik Zerbst/Anhalt, Germany

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Olivier Borens Service of Orthopaedics and Traumatology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland

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Andrej Trampuz Charité – Universitätsmedizin Berlin, Corporate Member of Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Center for Musculoskeletal Surgery (CMSC), Berlin, Germany

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-operation with plastic surgeons to perform a soft tissue and skin coverage procedure is necessary. Negative-pressure wound therapy is not recommended in PJI as the sponge becomes colonized with micro-organisms within days and is associated with the risk of

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Hagen Schmal Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark.
Department of Orthopaedics and Traumatology, Freiburg University Hospital, Freiburg, Germany.

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Michael Brix Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark.

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Mats Bue Department of Orthopaedic Surgery, Horsens Regional Hospital, Horsens, Denmark

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Anna Ekman Orthopaedic Department, Södersjukhuset, Stockholm, Sweden

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Nando Ferreira Division of Orthopaedics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa

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Hans Gottlieb Department of Orthopaedic Surgery, Herlev Hospital, Herlev, Denmark

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Søren Kold Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg University, Aalborg, Denmark

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Andrew Taylor Department of Orthopaedic Surgery, Nottingham University Hospitals, UK

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Peter Toft Tengberg Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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Ilija Ban Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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Danish Orthopaedic Trauma Society Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

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. After infection is sufficiently treated, bone and soft tissue are reconstructed using the described methods such as autograft or bone transport. A successful adjuvant in soft tissue management is negative-pressure wound therapy (NPWT), providing a chance

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Gautier Beckers Department of Surgery, Hôpital Maisonneuve-Rosemont, Montréal University, Montréal, Quebec, Canada
Personalized Arthroplasty Society, Atlanta, Georgia, USA

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Vincent Massé Department of Surgery, Hôpital Maisonneuve-Rosemont, Montréal University, Montréal, Quebec, Canada
Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada

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Pascal-André Vendittoli Department of Surgery, Hôpital Maisonneuve-Rosemont, Montréal University, Montréal, Quebec, Canada
Personalized Arthroplasty Society, Atlanta, Georgia, USA
Clinique Orthopédique Duval, Laval, Quebec, Canada

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Mina W Morcos Department of Surgery, Hôpital Maisonneuve-Rosemont, Montréal University, Montréal, Quebec, Canada
Personalized Arthroplasty Society, Atlanta, Georgia, USA

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. Closure should be done in a watertight fashion, and advanced dressing should be used in this high-risk population. The authors prefer using closed incisional negative pressure wound therapy to decrease subcutaneous hematoma and seroma and improve

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