Negative Pressure Wound Therapy Devices in Total Knee Arthroplasty

NCT07770633 — Not applicable, Not yet recruiting, 300 participants, The Cleveland Clinic

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Randomized Controlled Clinical Trial for Closed Incision Negative Pressure Wound Therapy (NPWT) Devices in Total Knee Arthroplasty (TKA)

RegistryNCT07770633
StatusNot yet recruiting
PhaseNot applicable
Study typeInterventional; randomized, parallel, masking: none, treatment
Enrollment300 (Estimated)
SponsorThe Cleveland Clinic (Other); collaborators: Stryker Instruments
ConditionsWound Surgical, Diabetes, Obesity, Chronic Kidney Diseases, Smoking
InterventionsNP Seal, PICO, Prevena (Device)
Datesstart 2026-09-01 (estimated), primary completion 2029-12-01 (estimated), completion 2030-12-01 (estimated), first posted 2026-08-18, last updated 2026-09-25

Related Papers Related Patents Related Grants Related Experts
All trials for Wound Surgical All trials for Diabetes All trials of NP Seal All trials of PICO

-Summary

This study is a single-center, prospective, randomized, open-label clinical trial evaluating three commercially available closed-incision negative pressure wound therapy (ciNPWT) devices: NPseal, PICO, and Prevena, in adult patients undergoing primary total knee arthroplasty (TKA) who meet predefined high-risk criteria for wound complications.

A total of approximately 300 participants will be enrolled and randomized in a 1:1:1 fashion to receive one of the three study dressings applied over the closed surgical incision at the end of the procedure. All participants will otherwise receive standard perioperative and postoperative care. The primary follow-up period will extend through 90 days after surgery.

The primary objective is to compare the incidence of 90-day surgical site complications, including superficial infection, wound dehiscence, seroma, and hematoma, across the three dressing groups. Secondary objectives include evaluation of device usability, patient experience, and device-related issues (such as loss of seal, alarms, tubing or pump problems, fluid saturation, and premature dressing changes), as well as assessment of the interaction between skin closure method and device performance.

Research-specific activities are limited to eligibility confirmation, informed consent, randomization, administration of a brief postoperative patient survey at approximately postoperative day 7 and/or dressing removal, provider assessment of the dressing at removal, and collection of clinical outcomes from the medical record. No additional blood draws, imaging, or invasive procedures are required for participation.

This study is designed to address a gap in the literature by providing head-to-head comparative data on commonly used ciNPWT systems in a high-risk primary TKA population, with the goal of informing postoperative wound management strategies in clinical practice.

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+Arms and interventions

ArmTypeInterventionsDescription
NP SealActive comparatorDevice: NP SealNP Seal is a single-use negative pressure dressing with an integrated mechanical pinch pump. It is applied over the closed incision.
PICO dressingActive comparatorDevice: PICOPICO is a single-use negative pressure dressing connected to a small portable pump.
Prevena dressingActive comparatorDevice: PrevenaPrevena is a closed-incision negative pressure dressing connected to a portable therapy unit.
  • NP Seal (Device): Designed to maintain negative pressure without an external battery-powered pump or canister.
  • PICO (Device): Designed to deliver negative pressure for up to 7 days and has visual alerts for issues such as air leaks, low battery, or dressing change
  • Prevena (Device): Designed to deliver continuous negative pressure over the closed incision and collect fluid in a separate canister.

+Outcome measures

Primary outcomes

  • Surgical complications [From day of surgery to 90days post-op]: Incidence of 90-day surgical site complications among patients receiving NPseal, PICO, or Prevena dressings.

Secondary outcomes

  • Patient Post-Operative Dressing Survey [From day of surgery to 90days post-op]: Patient-reported experience to evaluate device usability, satisfaction, and device-related issues (including adequacy of instructions, maintenance of seal/suction, device alarms or warnings, tubing or pump disconnections, fluid saturation, need for early dressing replacement, ease of use, provider communication regarding device benefits, and willingness to use the dressing again).
  • Provider Assessment Survey [From day of surgery to 90days post-op]: Clinical evaluation of the skin closure technique and the compatibility of device performance on wound healing

+Eligibility

Sex: All, ages: 18 Years to any, accepts healthy volunteers

Inclusion Criteria:

* Age 18 years or older
* Undergoing primary total knee arthroplasty
* Able to understand the study, provide informed consent, and participate in study procedures

Meet at least one of the following co-morbidities:

* BMI ≥35
* Diabetes
* Prior surgical incision(s) in the operative area
* Chronic kidney disease

Exclusion Criteria:

* Prisoners
* Pregnant women
* Patients who indicate they may not comply with post-operative instructions
* Patients with active bleeding