The aim of the present study was to evaluate the efficacy of the
vacuum-assisted closure (V.A.C.) system in the treatment of early hip joint
infections. 28 patients (11 m/17 f; mean age 71 y. [43-84]) with early hip joint
infections have been treated by means of the V.A.C.-
therapy. At least one surgical revision [1-7] has been unsuccessfully performed for
infection treatment prior to V.A.C.-application. Pathogen organisms could have been isolated in 22/28
wounds. During revision, cup
inlay and
prosthesis head have been exchanged and 1-3 polyvinylalcohol sponges inserted into the
wound cavity/ periprosthetically at an initial continuous pressure of 200 mm Hg. Postoperatively, a systemic antibiosis was given according to antibiogram. 48-72 h after surgery an alteration from haemorrhagic to serous fluid was observed in the V.A.C.-canister. Afterwards, the pressure was decreased to 150 mm Hg and remained at this level till sponge removal. After a mean period of 9 [3-16] days the
inflammation parameters have been retrogressive and the sponges were removed. An
infection eradication could be achieved in 26/28 cases. In the two remaining cases the infected
prosthesis had to be explanted and a
gentamicin-
vancomycin-loaded spacer has been implanted, respectively. At a total mean follow-up of 36 [12-87] months no
reinfection or
infection persistence was observed. The V.A.C.-system can be a valuable contribution in the treatment of early joint
infections when properly used. Indications should be early
infections with well-maintained soft-tissues for retention of the negative atmospheric pressure.