Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

Abstract

Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of diffi cult wounds, including post-sternotomy mediastinitis. Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A) and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B) between January 2006 and January 2010. Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was signifi cantly shorter in group A (mean, 13.5 ± 3.2 days) compared to 18 days (mean, 21.2 ± 16.4 days) in group B (p< 0.001). Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24%) patients in group B suffered recurrences. Hospital stay was signifi cantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days) (p= 0.001). Conclusion: A signifi cantly shorter healing time was confi rmed with vacuum assisted closure. Hospital stay remained signifi cantly shorter in group A (35 vs. 46 days).