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Comparative Study
. 2017 Dec;14(6):1335-1339.
doi: 10.1111/iwj.12808. Epub 2017 Sep 13.

Preliminary result with incisional negative pressure wound therapy and pectoralis major muscle flap for median sternotomy wound infection in a high-risk patient population

Federico Lo Torto  1 , Ambra Monfrecola  1 , Juste Kaciulyte  1 , Pedro Ciudad  2 , Donato Casella  1 , Diego Ribuffo  1 , Bruno Carlesimo  1
Affiliations
Comparative Study

Preliminary result with incisional negative pressure wound therapy and pectoralis major muscle flap for median sternotomy wound infection in a high-risk patient population

Federico Lo Torto et al. Int Wound J. 2017 Dec.

Abstract

Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. Prevena™ represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post-sternotomy DSWI following cardiac surgery was selected. Thrity patients were treated with MPMF and Prevena™ (study group). Control group consisted of 48 patients treated with MPMF and conventional wound dressings. During the follow-up period, 4 (13%) adverse events occurred in the study group, whereas 18 complications occurred (37·5%) in the control group. Surgical revision necessity and mean postoperative time spent in the intensive care unit were both higher in the control group. Our results evidenced Prevena™ system's ability in improving the outcome of DSWI surgical treatment with MPMF in a high-risk patient population.

Keywords: Deep sternal wound infection; Pectoralis major muscle flap; Prevena™.

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Figures

Figure 1
Figure 1
Post‐sternotomy deep sternal wound infection.
Figure 2
Figure 2
Monolateral pectoralis major muscle flap placed upon the sternal defect and fixated without tension.
Figure 3
Figure 3
Standardised 24‐cm‐long Prevena™ foam is placed upon the closed incision immediately after surgery.
Figure 4
Figure 4
Surgical wound's appearance immediately after removal of Prevena™.
Figure 5
Figure 5
Surgical wound's final appearance after stitches' removal.
See this image and copyright information in PMC

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