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A rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy.

Lindstedt Ingemansson, Sandra LU ; Ingemansson, Richard LU and Malmsjö, Malin LU (2011) In Journal of Cardiothoracic Surgery 6.
Abstract
OBJECTIVES:

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 edges of the sternum. The aim of the present study was to investigate whether a rigid barrier protects the heart and lungs against injury during NPWT.



METHODS:

Sixteen pigs underwent median sternotomy followed by NPWT at -120 mmHg for 24 hours, in the absence (eight pigs) or presence (eight pigs) of a rigid plastic disc between the heart and the sternal edges. The macroscopic appearance of... (More)
OBJECTIVES:

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 edges of the sternum. The aim of the present study was to investigate whether a rigid barrier protects the heart and lungs against injury during NPWT.



METHODS:

Sixteen pigs underwent median sternotomy followed by NPWT at -120 mmHg for 24 hours, in the absence (eight pigs) or presence (eight pigs) of a rigid plastic disc between the heart and the sternal edges. The macroscopic appearance of the heart and lungs was inspected after 12 and 24 hours of NPWT.



RESULTS:

After 24 hours of NPWT at -120 mmHg the area of epicardial petechial bleeding was 11.90 ± 1.10 cm2 when no protective disc was used, and 1.15 ± 0.19 cm2 when using the disc (p < 0.001). Heart rupture was observed in three of the eight animals treated with NPWT without the disc. Lung rupture was observed in two of the animals, and lung contusion and emphysema were seen in all animals treated with NPWT without the rigid disc. No injury to the heart or lungs was observed in the group of animals treated with NPWT using the rigid disc.



CONCLUSION:

Inserting a rigid barrier between the heart and the sternum edges offers protection against heart rupture and lung injury during NPWT. (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
Journal of Cardiothoracic Surgery
volume
6
publisher
BioMed Central
external identifiers
  • wos:000293064800001
  • pmid:21740574
  • scopus:79959968059
ISSN
1749-8090
DOI
10.1186/1749-8090-6-90
language
English
LU publication?
yes
id
0ab46737-1d7a-4bf2-be2a-b47f10330e2b (old id 2058791)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/21740574?dopt=Abstract
date added to LUP
2011-08-01 14:01:19
date last changed
2017-05-07 04:29:42
@article{0ab46737-1d7a-4bf2-be2a-b47f10330e2b,
  abstract     = {OBJECTIVES:<br/><br>
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 edges of the sternum. The aim of the present study was to investigate whether a rigid barrier protects the heart and lungs against injury during NPWT.<br/><br>
<br/><br>
METHODS:<br/><br>
Sixteen pigs underwent median sternotomy followed by NPWT at -120 mmHg for 24 hours, in the absence (eight pigs) or presence (eight pigs) of a rigid plastic disc between the heart and the sternal edges. The macroscopic appearance of the heart and lungs was inspected after 12 and 24 hours of NPWT.<br/><br>
<br/><br>
RESULTS:<br/><br>
After 24 hours of NPWT at -120 mmHg the area of epicardial petechial bleeding was 11.90 ± 1.10 cm2 when no protective disc was used, and 1.15 ± 0.19 cm2 when using the disc (p &lt; 0.001). Heart rupture was observed in three of the eight animals treated with NPWT without the disc. Lung rupture was observed in two of the animals, and lung contusion and emphysema were seen in all animals treated with NPWT without the rigid disc. No injury to the heart or lungs was observed in the group of animals treated with NPWT using the rigid disc.<br/><br>
<br/><br>
CONCLUSION:<br/><br>
Inserting a rigid barrier between the heart and the sternum edges offers protection against heart rupture and lung injury during NPWT.},
  articleno    = {90},
  author       = {Lindstedt Ingemansson, Sandra and Ingemansson, Richard and Malmsjö, Malin},
  issn         = {1749-8090},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {Journal of Cardiothoracic Surgery},
  title        = {A rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy.},
  url          = {http://dx.doi.org/10.1186/1749-8090-6-90},
  volume       = {6},
  year         = {2011},
}