Better Outcomes with a new Type of Pressure Wound Therapy for Mediastinitis after Cardiac Surgery

Main Article Content

Hayati Deniz
Yavuz Arslanoglu
Murat Ari

Keywords

Mediastinit, VAC therapy, Wound

Abstract

Background: The aim of the present study is to compare the clinical outcomes and survival in our 40 patients underwent NPWT with or without instillation treatment for mediastinitis after cardiac surgery.


Materials end Methods: In this study, we retrospectively compared the clinical outcome and survival in 40 patients undergoing VAC therapy with or without instillation treatment for DSWI after cardiac surgery. Only patients with mediastinitis those are consisting of sternum and presternal tissue infection after coronary bypass surgery were included in the present study.


Results: Mean age of patients was 58.86 ± 11.6 and 57 patients of them were female and 33 of them were male. Primary surgery among the 40 patients presenting with DSWI; was coronary artery bypass revascularization.


Conclusion: The use of VAC therapy with instillation has changed the management of complicated infected or colonized wounds and has become the standard of care our facility.

Downloads

Download data is not yet available.
Abstract 18 | PDF Downloads 13

References

1-Lu JCY, Grayson AD, Jha P, Srinivasan AK, Fabri BM. Risk factors for sternal wound infection and mid-term survival follewing coronary artery bypass surgery. Eur J Cardiovasc Surg 2003;23:943-9.
2-Gardlung B, Bitkover CY, Vaage J. Postoperative mediastinitis in cardiac surgery-microbiology and pathogenesis. Eur J Cardiovasc Surg 2002;21:825-30.
3-Argenta LC, Morykwas MJ Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563-576.
4-Sjögren J, Gustafsson R, Dobre M, Koul B, Ingemansson R, Algotsson L. Vacuum-assisted closure therapy in mediastinitis after heart transplantation. J Heart Lung Transplant 2004;23:506-7.
5-Garner J, Jarvis WR, Emori GT, Horan TC, Huges J. CDC definitions for nosocomial infections 1988. Am J Infect Control 1988;16:128-40.
6-El Oakley R, Wright J. Postoperative mediastinitis: clasification and management. Ann Thorac Surg 1996;61:1030-6.
7-De Feo M, Renzulli A, Isomeno G, et al. Variables predicting adverse outcome in patients with deep sternal wound infection. Ann Thoarc Surg 2001;71:324-31.
8-Jurkiewicz MJ, Bostwick J, Hester TR, Bishop JB, Craver J. Infected median sternotomy wound; successful treatment by muscle flaps. Ann Surg 1980;191:738-44.
9-Jones G, Jurkiewicz MJ, Bostwick J, et al. Management of the infected median sternotomy wound with muscle flaps: the Emory 20 year experience. Ann Surg 1997;225:766-76.
10-Douville EC, Asaph JW, Dworkin RJ, et al. Sternal preservation: beter way to treat most sternal wound compications after cardiac surgery. Ann Thorac Surg 2004;78:1659-64.
11-Catarino PA, Chamberlain MH, Wright NC, et al. High-pressure suction drainage via a polyurethane foam in the management of poststernotomy mediastinitis. Ann Thorac Surg 2000;70:1891-5.
12-Drosou A, Falabella A, Kirsner R. Antiseptics on wound: an area of controversy. Wound 2003;15:149-66.