The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study

Abstract

Background and Aims: Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi-d) in the treatment of DSWI.Methods: We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi-d. The NPWTi-d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3-min dwell time. Results:The NPWTi-d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in-hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). Conclusion:NPWTi-d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi-d in the control of infection and biofilm as well as in wound healing.

VAC Therapy as Part of Complex Treatment of Deep Sternal Wound Infection in Cardiosurgical Patients: First Experience

“…Надлишкові витрати виникають насамперед через лікування антибіотиками [6]. У літературних даних наголошується на тому, що значний прогрес у застосуванні терапії ран негативним тиском (vacuum assisted closure therapy [VAC-терапія]) радикально змінив курс лікування та результати пацієнтів із ГСРІ, знизивши госпітальну летальність із 36-52 % до ери VAC-терапії до близько 10 % на сьогодні [7].…”