Long term experiences with negative pressure wound therapy in combination with polyhexanid solution instillation technique for treatment of posttraumatic infections and osteomyelitis

This retrospective study assessed the effectiveness of Negative Pressure Wound Therapy with Instillation using polyhexanide 0.2% solution for treating infected chronic trauma-related wounds, open fractures, and posttraumatic osteomyelitis. A total of 67 patients (2014–2024) were categorized into posttraumatic osteomyelitis (N = 27), open fractures (N = 23), and soft tissue infections/trauma wounds (N = 17). The therapy combined surgical debridement and vacuum-assisted dressing with intermittent polyhexanide 0.2% instillation. Foam dressings were changed every 3–4 days, with concurrent antibiotic therapy. Statistical analysis showed significant reductions in bacterial specimens (99 to 20, p < 0.001), and a low reinfection of 10.2% in osteomyelitis and open fracture, which is lower compared to standard treatments (debridement, lavage and antibiotic loaded beads). The average treatment was 12.6 days with 3.22 dressing changes, with variations between the groups. CRP (C-reactive protein) levels significantly decreased from start to follow-up (p = 0.014). Over half of the cases achieved delayed primary closure, with osteomyelitis showing a longer duration of antibiotic therapy compared to the other groups. The most common risk factors were cardiovascular conditions, with an average of 3.17 risk factors per patient. While limited by its retrospective design and small sample size, this study provides a basis to hypothesize that Negative Pressure Wound Therapy with Instillation can be an effective adjunctive method in reducing bacterial load, may accelerate wound closure and lower infection recurrence, particularly for osteomyelitis and orthopaedic implant infections.