From open packing to negative wound pressure therapy. A critical overview of deep sternal wound infection treatment strategies after cardiac surgery

Abstract

Deep sternal wound infection is a challenging aspect of modern cardiac surgery. The considerable mortality rate, devastating morbidity and, negative impact on long-term survival has driven cardiac and plastic surgeons to seek a more advantageous treatment solution. This review summarizes progress in the field of deep sternal wound infection treatment after cardiac surgery. Emphasis is placed on outcomes analysis of contemporary treatment strategy based on negative pressure wound therapy followed by sternotomy wound reconstruction, and its comparison with conventional treatment modalities used afore. Furthermore, complications and drawbacks of treatment strategies are critically evaluated to outline current options for successfully managing this life-threatening complication following cardiac surgery.

The Impact of Deep Sternal Wound Infection on Mortality and Resource Utilization: A Population‐based Study

“…Of the 600,000 cardiac surgery procedures performed each year in the United States [1, 2], up to 3 % have been reported to develop a deep sternal wound infection (DSWI) or mediastinitis [2–9]. These devastating complications are associated with postoperative mortality rates as high as 30 % [2, 6, 7, 10–13] and more than double the treatment cost [5, 13, 14].…”

Use of a negative pressure wound therapy system over closed incisions option in preventing post‐sternotomy wound complications

“…Advancements in technology and materials make available a variety of treatments that can be used over closed surgical incisions: from traditional gauze dressings to hydrocolloids, growth factors, cultured skin tissues and negative pressure wound therapy (NPWT). 4 NPWT has been widely used for 20 years as a reliable method reducing hospital stay and improving the healing process in open surgical wounds. 1 More recent studies analysed the role of NPWT over closed surgical incisions.…”

“…Population is older and multiple risk factors for the development of both superficial and deep wound complications are frequently present. Advancements in technology and materials make available a variety of treatments that can be used over closed surgical incisions: from traditional gauze dressings to hydrocolloids, growth factors, cultured skin tissues and negative pressure wound therapy (NPWT) 4 . NPWT has been widely used for 20 years as a reliable method reducing hospital stay and improving the healing process in open surgical wounds 1 .…”