Advanced

Haemodynamic effects of negative pressure wound therapy when using a rigid barrier to prevent heart rupture.

Lindstedt Ingemansson, Sandra LU ; Ingemansson, Richard LU and Malmsjö, Malin LU (2011) In International Wound Journal 8. p.385-392
Abstract
Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up and damaged by the sharp sternum bone edges. The aim of this study was to investigate the haemodynamic effects of placing a rigid barrier over the heart to protect it from rupture during NPWT. Eight pigs underwent median sternotomy followed by NPWT at -70 and -120 mmHg, using foam, with or without a rigid plastic disc between the heart and the sternal edges. The heart frequency, cardiac output, mean systemic arterial pressure, mean pulmonary artery pressure,... (More)
Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up and damaged by the sharp sternum bone edges. The aim of this study was to investigate the haemodynamic effects of placing a rigid barrier over the heart to protect it from rupture during NPWT. Eight pigs underwent median sternotomy followed by NPWT at -70 and -120 mmHg, using foam, with or without a rigid plastic disc between the heart and the sternal edges. The heart frequency, cardiac output, mean systemic arterial pressure, mean pulmonary artery pressure, central venous pressure and left atrial pressure were recorded. Cardiac output was not affected by NPWT, regardless of whether a rigid barrier was used. Heart frequency decreased during NPWT without a disc, and showed a tendency towards a decrease when using a rigid disc. The blood pressure decreased during NPWT without a disc, and showed only a tendency towards a decrease when a disc was inserted between the heart and the sternum. In conclusion, the results of this haemodynamic study show that a rigid disc can safely be placed over the heart during NPWT, to prevent heart rupture. The haemodynamic effects of NPWT in sternotomy wounds are slightly reduced by the presence of the rigid disc. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Wound Journal
volume
8
pages
385 - 392
publisher
Wiley-Blackwell
external identifiers
  • wos:000292654600009
  • pmid:21585658
  • scopus:79960267862
ISSN
1742-481X
DOI
10.1111/j.1742-481X.2011.00803.x
language
English
LU publication?
yes
id
2b0b280c-51ba-43c4-b1da-2148d324008c (old id 1972450)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21585658?dopt=Abstract
date added to LUP
2011-06-07 20:14:24
date last changed
2017-01-01 07:37:28
@article{2b0b280c-51ba-43c4-b1da-2148d324008c,
  abstract     = {Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up and damaged by the sharp sternum bone edges. The aim of this study was to investigate the haemodynamic effects of placing a rigid barrier over the heart to protect it from rupture during NPWT. Eight pigs underwent median sternotomy followed by NPWT at -70 and -120 mmHg, using foam, with or without a rigid plastic disc between the heart and the sternal edges. The heart frequency, cardiac output, mean systemic arterial pressure, mean pulmonary artery pressure, central venous pressure and left atrial pressure were recorded. Cardiac output was not affected by NPWT, regardless of whether a rigid barrier was used. Heart frequency decreased during NPWT without a disc, and showed a tendency towards a decrease when using a rigid disc. The blood pressure decreased during NPWT without a disc, and showed only a tendency towards a decrease when a disc was inserted between the heart and the sternum. In conclusion, the results of this haemodynamic study show that a rigid disc can safely be placed over the heart during NPWT, to prevent heart rupture. The haemodynamic effects of NPWT in sternotomy wounds are slightly reduced by the presence of the rigid disc.},
  author       = {Lindstedt Ingemansson, Sandra and Ingemansson, Richard and Malmsjö, Malin},
  issn         = {1742-481X},
  language     = {eng},
  pages        = {385--392},
  publisher    = {Wiley-Blackwell},
  series       = {International Wound Journal},
  title        = {Haemodynamic effects of negative pressure wound therapy when using a rigid barrier to prevent heart rupture.},
  url          = {http://dx.doi.org/10.1111/j.1742-481X.2011.00803.x},
  volume       = {8},
  year         = {2011},
}