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Sternal stability at different negative pressures during vacuum-assisted closure therapy

Mokhtari, Arash LU ; Petzina, Rainer LU ; Gustafsson, Lotta LU ; Sjögren, Johan LU ; Malmsjö, Malin LU and Ingemansson, Richard LU (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)
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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
2007-08-20 09:23:37
date last changed
2019-03-12 01:35:00
@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 &lt; 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 (&gt; 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          = {http://dx.doi.org/10.1016/j.athoracsur.2006.04.085},
  volume       = {82},
  year         = {2006},
}