Authors: (including presenting author): :
Yuen LW(1), Chang WYE(1), Chow ML(1), Choy KL(1), Wan SY(1), Pang TY(1), Chan KY(1), Chan CY(1), Yu WS(1)
Affiliation: :
Department of Orthopaedics & Traumatology, Yan Chai Hospital
Keyword 1: :
Incisional Negative Pressure Wound Therapy
Keyword 2: :
Negative Pressure Wound Therapy
Keyword 4: :
Surgical Site Infection
Keyword 6: :
Hip Fracture
Introduction: :
The incidence of hip fractures among geriatric patients has progressively increased over recent decades, primarily due to the ageing population. At Yan Chai Hospital, more than 240 geriatric hip fracture patients undergo surgery each year. Surgical site infection (SSI) remains a devastating complication following hip fracture surgery, particularly in this high‑risk population. Given the high prevalence of comorbidities among geriatric patients with hip fractures, the SSI rate has been reported to reach 5.26% in the first quarter of 2025, contributing to prolonged hospitalization and increased mortality.
Objectives: :
To review the effectiveness of incisional negative pressure wound therapy (iNPWT) on reducing incidence of SSI in high-risk geriatric hip fracture patients.
Methodology: :
Eligibility was determined according to international multidisciplinary consensus recommendations. High‑risk patients were identified using an algorithm that assessed both individual patient risk factors and surgical risk factors for surgical site infections (SSIs). A total of sixty‑five geriatric hip fracture patients, classified as high‑risk for developing SSIs, were included in this cohort study. Patients received either incisional negative pressure wound therapy (iNPWT) or standard gauze dressings. The study was conducted between December 2024 and July 2025. The primary outcome was the incidence of superficial and deep SSIs within 30 days postoperatively, diagnosed according to the criteria of the Chief Infection Control Officer (CICO) Office and the Infection Control Branch (ICB) of the Centre for Health Protection (CHP). Secondary outcomes included wound dehiscence, mortality, and adverse skin events.
Result & Outcome: :
The two groups demonstrated comparable baseline characteristics. The incidence of superficial SSI was significantly lower in the iNPWT group at 0% (0/36) compared with 17.2% (5/29) in the standard gauze dressing group (p = 0.047; relative risk reduction 92.6%; number needed to treat [NNT] = 6 to prevent one case of SSI). No deep SSIs occurred in either group. The iNPWT group also showed lower rates of wound dehiscence (0% vs. 6.9%) and mortality (0% vs. 3.4%). No adverse skin events were observed in association with iNPWT. These findings support the protocolized use of iNPWT in this high-risk population.
