Management of complex pelvic-perineal soft tissue infection in open pelvic fractures: Comparison between conventional and modified instillation negative-pressure wound therapy

Abstract

Abstract Background Open pelvic fractures are associated with pelvic-perineal soft tissue injuries and pelvic infections as late complications. The study aimed to analyse and compare the clinical results and medical costs of the conventional and modified instillation negative-pressure wound therapy (cNPWT and m-iNPWT, respectively). Methods This retrospective study compared the outcomes of cNPWT and m-iNPWT for soft tissue management in patients with open pelvic fractures. We analysed the Injury Severity Score (ISS), hospital stay, medical costs, number of NPWT, time required to reach definite wound coverage, and occurrence of complications. Results Seventeen patients with open pelvic fractures were treated with NPWT. The median ISS (interquartile range) for m-iNPWT and cNPWT were 40 (26–48) and 43 (35–43), respectively. The numbers of NPWT changes were 6 (3–8) for m-iNPWT and 21 (20–32) for cNPWT. The time to wound coverage for patients who underwent m-iNPWT and cNPWT was 30 and 49 days, respectively. The overall medical costs of m-iNPWT and cNPWT were 80076 and 248395 USD. The hospital and intensive care unit (ICU) stay was 53 (41–70) and 12 (5–26) days for m-iNPWT and 167 (107–284) and 43 (23–151) days for cNPWT. One patient receiving cNPWT died of pelvic sepsis during ICU treatment. Conclusions Our study findings indicate that m-iNPWT would be a feasible method for complex pelvic soft tissue infection in open pelvic fractures to reduce complication rates, hospital stay, and medical costs.