![]() ![]() 9ĭisturbance in wound healing may be physiological and non-infectious, resulting in wound drainage for a short duration. 9 Wound healing starts with haemostasis, inflammation, proliferation, maturation and ends in remodelling, with any deviation within these phases resulting in delayed or abnormal healing of a surgical wound. Surgical wound healing has been divided into different phases needed to complete closure of the wound and restore the vital barrier to physical, chemical and biological pathogens. However, evidence-based clinical guidelines for the diagnosis and treatment of PWD in TJA are still lacking. 8 Much focus is now devoted to the prevention of PJI and the recognition and treatment of PWD should be a logical step in preventing PJI. 6 A 3.58 times increased risk of death exists after revision surgery for PJI and five-year mortality is 21%. It is the most common reason for revision within two years of TJA. 3, 7 PJI is the most common reason for revision TKA and third most common cause of revision THA. PJIs are associated with significant morbidity and mortality and place a heavy economic burden on healthcare facilities and resources. The rate of PJI in wounds that persistently drain post-operatively has been reported in various studies to range from 1.3% to up to 50%, with the wide range possibly attributable to a lack of standardized definition of persistent wound drainage used and the heterogenicity and retrospective nature of available literature. 4 Patel et al 4 showed that each extra day of PWD carried an additional 42% risk of wound infection in TKA and 29% risk of wound infection in THA. 3 PWD has been reported as a risk factor for periprosthetic joint infection (PJI). It is reported to occur in between 0.2% to 21% of all cases of primary TJA however, there is lack of agreement on the definition of PWD. ![]() 2 Persistent wound drainage (PWD) is a post-operative wound complication following TJA. 1, 2 Associated complications will subsequently increase in conjunction with this demand. The demand for TJA is increasing globally, with projections showing sustained increases beyond 2030. Primary total joint arthroplasty (TJA), including total hip arthroplasty (THA) and total knee arthroplasty (TKA), are highly successful, reproducible surgical procedures.
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