Enhanced strategy against mediastinitis with thoracic vascular graft infection: A combination of hydro‐debridement with pulsed lavage and negative pressure wound therapies

Abstract

Background We investigated the effects of hydrodebridement with pulsed lavage (HDPL) and negative pressure (NP) wound therapies, instead of excising the prosthetic graft, in patients with postoperative thoracic vascular graft infection (TVGI). Methods Between 2020 and 2021, five TVGI patients aged 49.6 ± 19.4 years old underwent a combined therapy of HDPL and NP. The patients underwent a two‐step procedure (first step: re‐sternotomy and HDPL; second step: NP) every 3 or 4 days. After negative tissue culture, the patients underwent omentum flap wrapping and skin closure. Results No hospital death was observed. The time to skin closure was 10.8 ± 3.4 days. The time to the day in which bacteria were not cultured was 3.5 ± 2.4 days. No recurrent infections occurred for 241 ± 186 postoperative days. Conclusion Our strategy for TVGI patients may contribute to (1) sufficient infection control, (2) physical rehabilitation, and (3) less invasiveness for high‐risk patients.

A combination of hydro-debridement with pulsed lavage and negative pressure wound therapies may enhance outcomes

“…Takagi et al proposed a combination therapy of hydro-debridement with pulsed lavage and NPWT for patients with DSWI with prosthetic graft infection. 15 In their study, intermittent hydro-debridement with pulsed lavage consisted of a high volume of saline solution and 0.005% gentian violet and significantly reduced the number of bacteria and the surgical site infection rate. 16 Moreover, pulsed lavage with gentian violet facilitated the removal of necrotic tissues.…”

A combination of hydrodebridement with pulsed lavage and negative pressure wound therapies may enhance outcomes

“…Continuous or intermittent irrigation and drainage contributes to the control of bacterial infections by washing the purulent and necrotic tissues, a strategy termed hydrodebridement. Takagi et al 15 proposed a combination therapy of hydrodebridement with pulsed lavage and NPWT for patients with DSWI with prosthetic graft infection. In their study, intermittent hydrodebridement with pulsed lavage consisted of a high volume of saline solution and 0.005% gentian violet and significantly reduced the number of bacteria and the surgical site infection rate 16 .…”