Sternal stability at different negative pressures during vacuum-assisted closure therapy
(2006) In Annals of Thoracic Surgery 82(3). p.1063-1067- Abstract
- Background. Vacuum-assisted closure (VAC) is a widely used therapy in patients with poststernotomy mediastinitis. The aim of this study was to evaluate sternal stability during VAC application at seven negative pressures (-50 to -200 mm Hg) in a porcine wound model. Methods. Six pigs underwent median sternotomy and 2 steel wires were fixed at each sternal side and connected to a traction device. The device was connected to a force transducer linked to a force recorder. VAC therapy was applied to the wound. At each negative pressure, the length and width of the wound were measured before and after traction was started. Traction was increased stepwise up to 400 N. Results. The diastasis induced by a certain lateral force was similar in... (More)
- Background. Vacuum-assisted closure (VAC) is a widely used therapy in patients with poststernotomy mediastinitis. The aim of this study was to evaluate sternal stability during VAC application at seven negative pressures (-50 to -200 mm Hg) in a porcine wound model. Methods. Six pigs underwent median sternotomy and 2 steel wires were fixed at each sternal side and connected to a traction device. The device was connected to a force transducer linked to a force recorder. VAC therapy was applied to the wound. At each negative pressure, the length and width of the wound were measured before and after traction was started. Traction was increased stepwise up to 400 N. Results. The diastasis induced by a certain lateral force was similar in wounds treated with -75, -125, and -175 mm Hg. At -75 mm Hg, a significant improvement (p < 0.01) in sternal stability was seen compared with the open-chest setting. This was not further improved at -125 or -175 mm Hg. High negative pressures (-150 to -200 mm Hg) in combination with a high lateral force (> 200 N) increased the risk of separation of the foam from the wound edges, with air leakage or organ rupture as a result. Conclusions. Our results suggest that low negative pressures (-50 to -100 mm Hg) stabilize the sternum as efficiently as high negative pressures (-150 to -200 mm Hg). Low negative pressures (-50 to -100 mm Hg) were more beneficial, however, because no air leakage or organ rupture was observed at these pressures. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/395344
- author
- Mokhtari, Arash LU ; Petzina, Rainer LU ; Gustafsson, Lotta LU ; Sjögren, Johan LU ; Malmsjö, Malin LU and Ingemansson, Richard LU
- organization
- publishing date
- 2006
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Thoracic Surgery
- volume
- 82
- issue
- 3
- pages
- 1063 - 1067
- publisher
- Elsevier
- external identifiers
-
- wos:000239996300045
- pmid:16928538
- scopus:33747330864
- ISSN
- 1552-6259
- DOI
- 10.1016/j.athoracsur.2006.04.085
- language
- English
- LU publication?
- yes
- id
- 4da3aa6c-0386-4a3f-9169-a2bdc74df170 (old id 395344)
- alternative location
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16928538&dopt=Abstract
- date added to LUP
- 2016-04-01 11:35:38
- date last changed
- 2024-01-07 13:18:21
@article{4da3aa6c-0386-4a3f-9169-a2bdc74df170, abstract = {{Background. Vacuum-assisted closure (VAC) is a widely used therapy in patients with poststernotomy mediastinitis. The aim of this study was to evaluate sternal stability during VAC application at seven negative pressures (-50 to -200 mm Hg) in a porcine wound model. Methods. Six pigs underwent median sternotomy and 2 steel wires were fixed at each sternal side and connected to a traction device. The device was connected to a force transducer linked to a force recorder. VAC therapy was applied to the wound. At each negative pressure, the length and width of the wound were measured before and after traction was started. Traction was increased stepwise up to 400 N. Results. The diastasis induced by a certain lateral force was similar in wounds treated with -75, -125, and -175 mm Hg. At -75 mm Hg, a significant improvement (p < 0.01) in sternal stability was seen compared with the open-chest setting. This was not further improved at -125 or -175 mm Hg. High negative pressures (-150 to -200 mm Hg) in combination with a high lateral force (> 200 N) increased the risk of separation of the foam from the wound edges, with air leakage or organ rupture as a result. Conclusions. Our results suggest that low negative pressures (-50 to -100 mm Hg) stabilize the sternum as efficiently as high negative pressures (-150 to -200 mm Hg). Low negative pressures (-50 to -100 mm Hg) were more beneficial, however, because no air leakage or organ rupture was observed at these pressures.}}, author = {{Mokhtari, Arash and Petzina, Rainer and Gustafsson, Lotta and Sjögren, Johan and Malmsjö, Malin and Ingemansson, Richard}}, issn = {{1552-6259}}, language = {{eng}}, number = {{3}}, pages = {{1063--1067}}, publisher = {{Elsevier}}, series = {{Annals of Thoracic Surgery}}, title = {{Sternal stability at different negative pressures during vacuum-assisted closure therapy}}, url = {{https://lup.lub.lu.se/search/files/2553217/625540.pdf}}, doi = {{10.1016/j.athoracsur.2006.04.085}}, volume = {{82}}, year = {{2006}}, }