Incisional negative pressure wound therapy in reconstructive surgery of poststernotomy mediastinitis

Abstract

The efficacy of negative pressure wound therapy in the treatment of poststernotomy mediastinitis has been revealed in many reports. The present retrospective observational study examined the efficacy of incisional negative pressure wound therapy in the reconstructive surgery of poststernotomy mediastinitis. We retrospectively examined 1034 consecutive patients, who underwent median sternotomy in the period between October 2013 and September 2015. Mediastinitis developed in 21 patients (2%), who subsequently underwent surgical reconstruction. We applied incisional negative pressure wound therapy (iNPWT) after primary closure of the wound over redon drains in ten patients (iNPWT + redon group). In 11 patients, only redons were used (redons only group). We observed the time between the introduction and removal of redon drains, hospital stay until final wound closure and the rate of failure of treatment. Failure of treatment is defined as the need for further surgical reconstruction. In the iNPWT + redon group, the duration of redon drainage therapy was 6·9 ± 5·2 days versus 13·36 ± 11·58 in the redons only group. Hospital stay was 11·4 ± 8·6 versus 101·64 ± 89·2, and failure of treatment was 10% versus 45·5%, respectively. The primary results of this study appear to support the beneficial effect of iNPWT after radical wound reconstruction.

Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy

“…In this study, the decreased SSSI rate of iNPWT treated patients went hand in hand with a significantly shortened length of hospital stay. The data in the literature concerning length of hospital stay when comparing iNPWT and SSD do vary, depending on the surgical procedure . This could have been explained by a variety of factors others than wound healing, e.g., postoperative paralysis, diarrhea and concomitant diseases.…”

Negative pressure wound therapy for patients with mediastinitis: A meta‐analysis

“…In further screening, 81 articles were excluded because of the design of the study, insufficient data, and type of articles. Finally, six papers [13][14][15][16][17][18] were selected for analysis. Figure 1 shows the flowchart of identification, inclusion and exclusion, reflecting the search process, and the reasons for exclusion.…”

Effective Combination of Incisional Negative Pressure Wound Therapy and Radical Reconstructive Surgery in the Treatment of Post-Sternotomy Mediastinitis Caused by Methicillin Resistant Staphylococcus aureus

“…Dead spaces should be drained to avoid the development of seroma and prevent infection. A novel method to reach this goal is by applying incisional NPWT over the reconstructed wound [7]. This can lead to the accelerated obliteration of dead spaces and earlier removal of Redon drains, which could result in a shorter hospitalization time.…”