Preliminary outcome of treatment of postoperative primarily closed sternotomy wounds treated using negative pressure wound therapy

Abstract

Hospital infections, and in particular infections of the surgical site are a common problem of the procedural departments. Due to continuous progress of surgical techniques and patient population getting older with multiple co-morbidities, multidirectional actions need to be taken to avoid these infections or, if they do occur, achieve optimal treatment outcomes. Vacuum wound therapy is one of the directions that has been developed over the recent years. The aim of the study evaluate wound healing in patients after an off-pump coronary artery bypass grafting procedure, using the internal mammary artery, treated with negative pressure wound therapy system.

Material and methods: This prospective, open label study evaluated healing of postoperative sternotomy wounds after their primary closure with negative pressure wound therapy, using continuous negative pressure of -80 mmHg in 40 patients and 40 patients in a control group in whom conventional dressings were applied in the postoperative period.

Results: The number of patients in whom primary wound healing occurred without complications was significantly higher in the negative pressure wound therapy group versus the control group (x2 test =4.50, p=0.0339) and the number of total superficial infections was significantly smaller versus the control group (x2 test =5; p=0.0254). Antibiotic therapy was also initiated significantly less often as compared to the group treated with conventional dressings (x2 test = 4.11; p=0.0425).

Conclusions: Negative pressure wound therapy after primary wound closure reduces the risk of superficial infections in the population with multiple risk factors of complications in the sternotomy wound healing.