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Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-days mortality in 176 patients with deep sternal wound infection.

Sjögren, Johan LU ; Gustafsson, Ronny LU ; Nilsson, Johan LU ; Lindstedt Ingemansson, Sandra LU ; Nozohoor, Shahab LU and Ingemansson, Richard LU (2010) In Interactive Cardiovascular and Thoracic Surgery Dec.
Abstract
Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and... (More)
Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and two debridement related). Furthermore, two patients had debridement-related bleedings from the venous bypass grafts during wound dressing change. The very low 30-day mortality (1.1%) following DSWI supports the use of NPWT. Overall, even if major bleeding complications may occur, the risk of RV rupture seems to be outweighed by the benefit of superior infection control. However, surgical experience is recommended when debriding sternal wounds and we recommend the use of a wound dressing, such as paraffin gauze, in order to protect the RV from direct contact with the polyurethane foam. Keywords: Wound infection; Sternum; Negative-pressure wound therapy; Outcome. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Interactive Cardiovascular and Thoracic Surgery
volume
Dec
publisher
European Association of Cardio-Thoracic Surgery
external identifiers
  • pmid:21106567
  • scopus:79551602103
ISSN
1569-9285
DOI
10.1510/icvts.2010.252668
language
English
LU publication?
yes
id
7356da71-8d5e-4abb-b08c-a3f2cc95fdb0 (old id 1731559)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21106567?dopt=Abstract
date added to LUP
2010-12-01 13:49:03
date last changed
2018-05-29 10:49:30
@article{7356da71-8d5e-4abb-b08c-a3f2cc95fdb0,
  abstract     = {Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and two debridement related). Furthermore, two patients had debridement-related bleedings from the venous bypass grafts during wound dressing change. The very low 30-day mortality (1.1%) following DSWI supports the use of NPWT. Overall, even if major bleeding complications may occur, the risk of RV rupture seems to be outweighed by the benefit of superior infection control. However, surgical experience is recommended when debriding sternal wounds and we recommend the use of a wound dressing, such as paraffin gauze, in order to protect the RV from direct contact with the polyurethane foam. Keywords: Wound infection; Sternum; Negative-pressure wound therapy; Outcome.},
  author       = {Sjögren, Johan and Gustafsson, Ronny and Nilsson, Johan and Lindstedt Ingemansson, Sandra and Nozohoor, Shahab and Ingemansson, Richard},
  issn         = {1569-9285},
  language     = {eng},
  publisher    = {European Association of Cardio-Thoracic Surgery},
  series       = {Interactive Cardiovascular and Thoracic Surgery},
  title        = {Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-days mortality in 176 patients with deep sternal wound infection.},
  url          = {http://dx.doi.org/10.1510/icvts.2010.252668},
  volume       = {Dec},
  year         = {2010},
}