The impact of deep sternal wound infections treated by negative pressure on early, 1 year and late mortality: A longitudinal case‐control study

Drossos, George; Ampatzidou, Fotini; Baddour, Antonios; Madesis, Athanasios; Karaiskos, Theodoros

doi:10.1111/jocs.14296

Cited by 7 publications

(3 citation statements)

References 26 publications

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“…[16][17][18] However, reconstruction failure and high mortality have not been well addressed. 19 The reason for this may be related to the late time for plastic surgeons to contact DSWI patients. Most patients with non-healing wounds after cardiac surgery will continue to be treated in cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac surgeons and plastic surgeons have always been cautious in treating DSWI patients and their wound healing, and tried out a variety of modalities such as NPWT alone, suture after debridement, and various tissue flap reconstruction 16‐18 . However, reconstruction failure and high mortality have not been well addressed 19 . The reason for this may be related to the late time for plastic surgeons to contact DSWI patients.…”

Section: Discussionmentioning

confidence: 99%

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A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet‐rich plasma and negative pressure trauma therapy

Song

Chu

Zhang

et al. 2023

International Wound Journal

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Deep sternal wound infection (DSWI) is a relatively complex wound in wound reconstruction surgery. Because plastic surgeons deal with DSWI patients late. The primary healing (healing by first intention) after reconstruction of DSWI is restricted by many preoperative risk factors. The purpose of this study is to explore and analyse the risk factors of primary healing failure in patients with DSWI treated with platelet‐rich plasma (PRP) and negative pressure trauma therapy (NPWT). 115 DSWI patients treated with the PRP and NPWT (PRP + NPWT) modality were retrospectively (2013‐2021) analysed. They were divided into two groups according to primary healing results after the first PRP + NPWT treatment. Univariate and multivariate analyses were used to compare the data of the two groups to find out the risk factors and their optimal cut‐off values were identified by ROC analysis. The primary healing results, debridement history, wound size, sinus, osteomyelitis, renal function, bacterial culture, albumin (ALB), platelet (PLT) between the two groups were significantly different (P < 0.05). Binary logistic regression showed that osteomyelitis, sinus, ALB and PLT were the risk factors affecting primary healing outcomes (P < 0.05). ROC analysis showed that AUC for ALB in the non‐primary healing group was 0.743 (95% CI: 0.650‐0.836, P < 0.05) and its optimal cutoff value of 31 g/L was associated with primary healing failure with a sensitivity of 96.9% and specificity of 45.1%. AUC for PLT in the non‐primary healing group was 0.670 (95% CI: 0.571 ~ 0.770, P < 0.05) its optimal cutoff value of 293 × 109/L was associated with primary healing failure with a sensitivity of 72.5% and specificity of 56.3%. In the cases included in this study, the success rate of primary healing of DSWI treated with PRP + NPWT was not affected by the most common preoperative risk factors for wound non‐union. It is indirectly confirmed that PRP + NPWT is an ideal treatment. However, it should be noted that it will still be adversely affected by sinus osteomyelitis, ALB and PLT. The patients need to be carefully evaluated and corrected before reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet‐rich plasma and negative pressure trauma therapy

Song

Chu

Zhang

et al. 2023

International Wound Journal

View full text Add to dashboard Cite

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“…Compared with ordinary mediastinal tube drainage after debridement, NPWT can optimize the treatment efficiency, reduce patients' pain and maintain a continuous "debridement-like" effect. NPWT can induce venous gradient hydrostatic pressure difference, promote blood flow, reduce local osmotic active molecules effectively, reduce tissue edema, reduce microcirculation damage, maintain the tissue blood supply, reduce residual flushing fluid and inflammatory exudation, and significantly reduce patients' pain by stabilizing the sternum halves, shorten rehabilitation time [45][46][47]. The risk of secondary infection and the emergence of multidrug resistant microorganisms or the erosion of the exposed right ventricle, large blood vessels and bypass pipes resulting in fatal bleeding will seriously affect the late secondary healing effect of NPWT [11].…”

Section: Keep the Drainage Unobstructedmentioning

confidence: 99%

Review on risk factors, classification, and treatment of sternal wound infection

Song

Chu

Sun

et al. 2023

J Cardiothorac Surg

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Sternal wound infection (SWI) is the most common complication of the median sternal incision. The treatment time is long, and the reconstruction is difficult, which causes challenges for surgeons. Plastic surgeons were often involved too late in such clinical scenarios when previous empirical treatments failed and the wound damage was relatively serious. Accurate diagnosis and risk factors against sternal wound infection need to be in focus. Classification of different types of sternotomy complications post-cardiac surgery is important for specific categorization and management. Not familiar with this kind of special and complex wound, objectively increasing the difficulty of wound reconstruction. The purpose of this comprehensive review is to review the literature, introduce various SWI risk factors related to wound nonunion, various classification characteristics, advantages and disadvantages of various wound reconstruction strategies, to help clinicians understand the pathophysiological characteristics of the disease and choose a better treatment method.

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Efficacy of incisional negative pressure therapy in preventing post-sternotomy wound complications

Traylor

Bhatia

Blackhurst

et al. 2023

The American Journal of Surgery

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The impact of deep sternal wound infections treated by negative pressure on early, 1 year and late mortality: A longitudinal case‐control study

Abstract: Background/Aim: Deep sternal wound infection (DSWI) after cardiac surgery, is a rare complication that can be fatal. Due to a lack of available data, we compared early in-hospital, 1-year and long-term mortality in patients with DSWI.

Cited by 7 publications

References 26 publications

A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet‐rich plasma and negative pressure trauma therapy

A study on the preoperative risk factors for primary healing failure in the reconstruction of deep sternal wound infection with platelet‐rich plasma and negative pressure trauma therapy

Review on risk factors, classification, and treatment of sternal wound infection

Efficacy of incisional negative pressure therapy in preventing post-sternotomy wound complications

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