Hospital infections, and in particular infections of the surgical site are a common problem of the procedural departments. Due to continuous progress of surgical techniques and patient population getting older with multiple co-morbidities, multidirectional actions need to be taken to avoid these infections or, if they do occur, achieve optimal treatment outcomes. Vacuum wound therapy is one of the directions that has been developed over the recent years.evaluate wound healing in patients after an off-pump coronary artery bypass grafting procedure, using the internal mammary artery, treated with negative pressure wound therapy system.This prospective, open label study evaluated healing of postoperative sternotomy wounds after their primary closure with negative pressure wound therapy, using continuous negative pressure of -80 mmHg in 40 patients and 40 patients in a control group in whom conventional dressings were applied in the postoperative period.The number of patients in whom primary wound healing occurred without complications was significantly higher in the negative pressure wound therapy group versus the control group (xNegative pressure wound therapy after primary wound closure reduces the risk of superficial infections in the population with multiple risk factors of complications in the sternotomy wound healing.

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There are two surgical methods for atrial fibrillation (AF) treatment: Maze and corridoring procedures. The first one prevents AF occurrence by performing multiple atriotomies. During the second procedure a corridor between a sino-atrial and the AV node is created together with an electrical isolation of the atria. During 1992 and 1993 seven patients, aged 27-55, mean 43-years-old, with recurrent, resistant to standard therapy AF were referred for surgical treatment to our department. Additional diagnoses include: concealed WPW syndrome in 1 patient, atrial septal defect (ASD) in 3 patients, coronary artery disease in 1 patient. Maze procedure was performed solely in 1 patient, in another together with 2 accessory pathways ablation, in 3 patients with ASD closure and in 1 patient with 2 bypass grafts. In one patient corridoring procedure was performed. Normal sinus rhythm was restored in every patient from 7 to 26 days after the procedure. No surgical complications were noted during the postoperative period. Mechanical function of the atria was documented with echo Doppler 2-6 weeks after the operation. No evidence for AF recurrence was noted within 3-14 months (mean 5 months) of follow-up. The preliminary results of Maze and corridoring procedures are encouraging.

Blunt chest trauma is generally the result of traffic accidents. Myocardial rupture is found in 10-15% of the victims of such accidents and, unfortunately, is characterised by a high mortality rate of up to 90%. Our case study involves a 42-year-old man who was hit in the precordial region with a wooden block, approximately 7 cm × 7 cm × 40 cm, while working using a buzz saw. On admission, the patient was conscious, yet in a poor general condition. However, blood pressure of 80/60 mm Hg, and clear lungs on auscultation were observed, heart rate of 110/min was present, and a regular sinus. Standard ECG showed tachycardia of 110/min, normal QRS voltage complexes were present, no signs of acute myocardial ischaemia were observed. The chest X-ray revealed only slight parenchymal consolidations in the right cardiophrenic angle and a slightly enlarged heart silhouette. A computed tomography of the chest revealed contusion to the inferior segment of the right lung and fluid in the pericardial sac. Laboratory tests showed increased plasma concentration of troponin I -17.86 ng/mL. Due to progressive deterioration and developing shock, bedside transthoracic echocardiography (TTE) was performed, which detected cardiac tamponade with a large volume of fluid and thrombus, 3 cm thick, surrounding the apex of the heart and the right ventricle as well as a compressed wall of the right atrium, which was well filled in. However, colour Doppler echocardiography visualised neither the site of the heart injury nor abnormalities of the ascending aorta, nor the site of blood leakage to the pericardial sac (Fig. 1). Blood pressure was stabilised by dopamine infusion. The patient was urgently transferred directly to the surgical suite of the Department of Cardiac Surgery at the Provincial Hospital, located about 40 km from our centre. On opening the pericardial sac, the presence of a large volume of fresh blood and thrombus was detected, as well as a rupture to the right atrial free wall, near the ostium of the inferior vena cava, 1.5 cm large. The rupture was stitched; the surgery was performed 21 h following the chest trauma. Twenty days after the patient's admission, he was discharged in a generally good condition. Five weeks following the incident, control echocardiography was performed which confirmed the correct function of the myocardium and a lack of fluid in the pericardial cavity (Fig. 2).

The study aimed to validate the European System for Cardiac Operative Risk Evaluation score (EuroSCORE II) in patients with atrial fibrillation (AF). All data were retrieved from the National Registry of Cardiac Surgery Procedures (KROK). EuroSCORE II calibration and discrimination performance was evaluated. The final cohort consisted of 44,172 patients (median age 67, 30.8% female, 13.4% with AF). The in-hospital mortality rate was 4.14% (N = 1830), and 5.21% (N = 2303) for 30-day mortality. EuroSCORE II significantly underestimated mortality in mild- and moderate-risk populations [Observed (O):Expected (E)—1.1, 1.16). In the AF subgroup, it performed well [O:E—0.99), whereas in the very high-risk population overestimated mortality (O:E—0.9). EuroSCORE II showed better discrimination in AF (−) [area under curve (AUC) 0.805, 95% CI 0.793–0.817)] than in AF (+) population (AUC 0.791, 95%CI 0.767–0.816), P < 0.001. The worst discriminative performance for the AF (+) group was for coronary artery bypass grafting (CABG) (AUC 0.746, 95% CI 0.676–0.817) as compared with AF (−) population (AUC 0.798, 95% CI 0.774–0.822), P < 0.001. EuroSCORE II is more accurate for patients with AF. However, it underestimated mortality rates for low-to-moderate-risk patients and had a lower ability to distinguish between high- and low-risk patients with AF, particularly in those undergoing coronary artery bypass grafting.