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C-reactive protein and leucocyte counts drop faster using the HeartShield® device in patients with DSWI.

Lindstedt Ingemansson, Sandra LU ; Malmsjö, Malin LU and Ingemansson, Richard LU (2015) In International Wound Journal 12(2). p.189-194
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 disc (HeartShield™) has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up by the negative pressure and damaged by the sharp sternum bone edges. Seven patients treated with conventional NPWT and seven patients treated with NPWT with a protective barrier disc (HeartShield) were compared with regard to bacterial clearance and infection parameters including C-reactive protein levels and leucocyte counts. C-reactive protein levels and leucocyte counts dropped faster and bacterial clearance occurred earlier in the... (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 disc (HeartShield™) has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up by the negative pressure and damaged by the sharp sternum bone edges. Seven patients treated with conventional NPWT and seven patients treated with NPWT with a protective barrier disc (HeartShield) were compared with regard to bacterial clearance and infection parameters including C-reactive protein levels and leucocyte counts. C-reactive protein levels and leucocyte counts dropped faster and bacterial clearance occurred earlier in the HeartShield® group compared with the conventional NPWT group. Negative biopsy cultures were shown after 3·1 ± 0·4 NPWT dressing changes in the HeartShield group, and after 5·4 ± 0·6 NPWT dressing changes in the conventional NPWT group (P < 0·001). All patients were followed up with clinical check-up after 3 months. None of the patients in the HeartShield group had any signs of reinfection such as deep sternal wound infection (DSWI) or sternal fistulas, whereas in the conventional NPWT group, two patients had signs of sternal fistulas that demanded hospitalisation. HeartShield hiders the right ventricle to come into contact with the sharp sternal edges during NPWT and thereby protects from heart damage. This study shows that using HeartShield is beneficial in treating patients with DSWI. Improved wound healing by HeartShield may be a result of the efficient drainage of wound effluents from the thoracic cavity. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Wound Journal
volume
12
issue
2
pages
189 - 194
publisher
Wiley-Blackwell
external identifiers
  • pmid:23651118
  • wos:000351626400013
  • scopus:84925217558
ISSN
1742-481X
DOI
10.1111/iwj.12079
language
English
LU publication?
yes
id
37291133-ae31-4457-ba16-202b124944fa (old id 3804818)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23651118?dopt=Abstract
date added to LUP
2013-06-06 15:29:44
date last changed
2017-01-01 04:09:59
@article{37291133-ae31-4457-ba16-202b124944fa,
  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 disc (HeartShield™) has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up by the negative pressure and damaged by the sharp sternum bone edges. Seven patients treated with conventional NPWT and seven patients treated with NPWT with a protective barrier disc (HeartShield) were compared with regard to bacterial clearance and infection parameters including C-reactive protein levels and leucocyte counts. C-reactive protein levels and leucocyte counts dropped faster and bacterial clearance occurred earlier in the HeartShield® group compared with the conventional NPWT group. Negative biopsy cultures were shown after 3·1 ± 0·4 NPWT dressing changes in the HeartShield group, and after 5·4 ± 0·6 NPWT dressing changes in the conventional NPWT group (P &lt; 0·001). All patients were followed up with clinical check-up after 3 months. None of the patients in the HeartShield group had any signs of reinfection such as deep sternal wound infection (DSWI) or sternal fistulas, whereas in the conventional NPWT group, two patients had signs of sternal fistulas that demanded hospitalisation. HeartShield hiders the right ventricle to come into contact with the sharp sternal edges during NPWT and thereby protects from heart damage. This study shows that using HeartShield is beneficial in treating patients with DSWI. Improved wound healing by HeartShield may be a result of the efficient drainage of wound effluents from the thoracic cavity.},
  author       = {Lindstedt Ingemansson, Sandra and Malmsjö, Malin and Ingemansson, Richard},
  issn         = {1742-481X},
  language     = {eng},
  number       = {2},
  pages        = {189--194},
  publisher    = {Wiley-Blackwell},
  series       = {International Wound Journal},
  title        = {C-reactive protein and leucocyte counts drop faster using the HeartShield® device in patients with DSWI.},
  url          = {http://dx.doi.org/10.1111/iwj.12079},
  volume       = {12},
  year         = {2015},
}