Does geography influence wound healing following revision total hip arthroplasty for periprosthetic joint infection? A retrospective comparative cohort study
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20262025Keywords:
Periprosthetic joint infection, Revision total hip arthroplasty, Vacuum-assisted closure, Wound healing, India, Democratic republic of CongoAbstract
Background: Periprosthetic joint infection (PJI) after revision total hip arthroplasty (THA) poses significant wound-management challenges. Outcomes following vacuum-assisted closure (VAC) therapy vary and may be influenced by regional microbiology and host soft-tissue characteristics.
Methods: This retrospective comparative cohort study (2019-2025) included adults undergoing revision THA for chronic PJI at a tertiary center. Patients were grouped by geographic origin: India (n=20) and Democratic Republic of Congo (DRC; n=18). Demographics, microbiology, postoperative wound gaping, debridement and VAC sessions, soft-tissue reconstruction, and time to complete wound healing were analysed using non-parametric statistics.
Results: The Indian cohort was younger (60.3 vs 67.8 years; p=0.010) but required more debridement’s (3.1 vs 2.3; p=0.031), VAC sessions (2.7 vs 1.6; p=0.003), and flap reconstructions (70% vs 22%). Initial wound gaping occurred at a similar postoperative interval in both cohorts; however, healing time was significantly longer in Indian patients (36.8 vs 18.2 days; p=0.002). Klebsiella predominated in the Indian cohort, whereas Pseudomonas was more common in DRC patients.
Conclusions: Geographic differences in wound behaviour following revision THA for PJI suggest that regional microbiology and host soft-tissue factors influence VAC effectiveness and healing outcomes, supporting population-specific wound management strategies.
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