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Negative pressure therapy as a treatment modality for surgical site infection in cardiac surgery
M Simek, P Nemec, B Zalesak, R Hajek, M Kalab, L Jecminkova
Jazyk angličtina Země Belgie
- MeSH
- délka pobytu MeSH
- infekce chirurgické rány MeSH
- kardiochirurgické výkony MeSH
- koronární bypass MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- terapie ran pomocí řízeného podtlaku MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
BACKGROUND: Negative pressure therapy (NPT), primarily introduced for the treatment of pressure ulcers or chronic debilitating wounds, has recently emerged as a novel treatment strategy in the field of cardiac surgery, providing superior results to the conventional therapeutic strategies. PATIENTS AND METHODS: From November 2004 to October 2005, 25 patients underwent NPT (negative pressure therapy). Four patients (16%) were treated for extensive leg-wound infections, 10 (40%) were treated for superficial sternal wound infections and 11 (44%) for deep sternal wound infections. The median age was 67.9 years (range 48 to 79) and the median BMI was 34.2 kg/m2 (range 28 to 41). Because of wound infection complications, 11 patients (44%) were re-admitted to the department. In 13 patients (52%), NPT was employed after the failure of the conventional treatment strategy. RESULTS: All 25 patients were successfully healed. In-hospital mortality was 0% and 30-day survival was 100%. The overall length of hospitalization reached 36.4 days (range 11 to 62). The median number of dressing changes was 4.9 (range 3 to 9). The median NPT treatment time until the surgical closure was 9.7 days (range 6 to 24 days). In 17 patients (68%), the excessive residual sternal defect required a local advancement flap transfer. One patient (4%) with a chronic wire-related fistula was re-admitted 6 months after NPT therapy. CONCLUSION: NPT therapy can be considered as an effective treatment strategy associated with a low risk of procedure failure and wound infection recurrence, particularly in the management of sternal wound infection after cardiac surgery.
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- $a Department of Cardiac Surgery, University Hospital and Palacky University Faculty of Medicine, Olomouc, Czech Republic. martin.simek@c-mail.cz
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- $a BACKGROUND: Negative pressure therapy (NPT), primarily introduced for the treatment of pressure ulcers or chronic debilitating wounds, has recently emerged as a novel treatment strategy in the field of cardiac surgery, providing superior results to the conventional therapeutic strategies. PATIENTS AND METHODS: From November 2004 to October 2005, 25 patients underwent NPT (negative pressure therapy). Four patients (16%) were treated for extensive leg-wound infections, 10 (40%) were treated for superficial sternal wound infections and 11 (44%) for deep sternal wound infections. The median age was 67.9 years (range 48 to 79) and the median BMI was 34.2 kg/m2 (range 28 to 41). Because of wound infection complications, 11 patients (44%) were re-admitted to the department. In 13 patients (52%), NPT was employed after the failure of the conventional treatment strategy. RESULTS: All 25 patients were successfully healed. In-hospital mortality was 0% and 30-day survival was 100%. The overall length of hospitalization reached 36.4 days (range 11 to 62). The median number of dressing changes was 4.9 (range 3 to 9). The median NPT treatment time until the surgical closure was 9.7 days (range 6 to 24 days). In 17 patients (68%), the excessive residual sternal defect required a local advancement flap transfer. One patient (4%) with a chronic wire-related fistula was re-admitted 6 months after NPT therapy. CONCLUSION: NPT therapy can be considered as an effective treatment strategy associated with a low risk of procedure failure and wound infection recurrence, particularly in the management of sternal wound infection after cardiac surgery.
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