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. 2023 Jul 16;6(7):e1430.
doi: 10.1002/hsr2.1430. eCollection 2023 Jul.

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

Olimpiu Bota  1 , Feras Taqatqeh  1 , Florian Bönke  1 , Jörg Nowotny  1 , Klaus Matschke  2 , Kevin Bienger  1 , Adrian Dragu  1
Affiliations

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

Olimpiu Bota et al. Health Sci Rep. .

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.

Keywords: cardiac surgery; instillation; negative pressure wound therapy; surgical wound infection; wound healing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
DSWI with open thorax before debridement.
Figure 2
Figure 2
Mediastinal wound after radical en bloc sternectomy.
Figure 3
Figure 3
Resected hemisternum specimens.
Figure 4
Figure 4
Mediastinal wound after 5 days NPWTi‐d.
Figure 5
Figure 5
Mediastinal wound after 10 days NPWTi‐d. Patient in lateral decubitus for flap closure.
Figure 6
Figure 6
After closure with pedicled Latissimus dorsi musculocutaneous flap.
Figure 7
Figure 7
Result 1‐year postoperative.
See this image and copyright information in PMC

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