Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-days mortality in 176 patients with deep sternal wound infection.
Sjögren, Johan LU ; Gustafsson, Ronny LU ; Nilsson, Johan LU
; Lindstedt Ingemansson, Sandra
LU
; Nozohoor, Shahab
LU
and Ingemansson, Richard
LU
(2011)
In Interactive Cardiovascular and Thoracic Surgery
12(2).
p.117-120
- Abstract
- Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and... (More)
- Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and two debridement related). Furthermore, two patients had debridement-related bleedings from the venous bypass grafts during wound dressing change. The very low 30-day mortality (1.1%) following DSWI supports the use of NPWT. Overall, even if major bleeding complications may occur, the risk of RV rupture seems to be outweighed by the benefit of superior infection control. However, surgical experience is recommended when debriding sternal wounds and we recommend the use of a wound dressing, such as paraffin gauze, in order to protect the RV from direct contact with the polyurethane foam. Keywords: Wound infection; Sternum; Negative-pressure wound therapy; Outcome. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1731559
- author
- Sjögren, Johan
LU
; Gustafsson, Ronny
LU
; Nilsson, Johan
LU
; Lindstedt Ingemansson, Sandra
LU
; Nozohoor, Shahab
LU
and Ingemansson, Richard
LU
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Interactive Cardiovascular and Thoracic Surgery
- volume
- 12
- issue
- 2
- pages
- 117 - 120
- publisher
- European Association of Cardio-Thoracic Surgery
- external identifiers
-
- pmid:21106567
- scopus:79551602103
- pmid:21106567
- ISSN
- 1569-9285
- DOI
- 10.1510/icvts.2010.252668
- language
- English
- LU publication?
- yes
- id
- 7356da71-8d5e-4abb-b08c-a3f2cc95fdb0 (old id 1731559)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/21106567?dopt=Abstract
- date added to LUP
- 2016-04-04 08:28:30
- date last changed
- 2022-01-29 03:26:51
@article{7356da71-8d5e-4abb-b08c-a3f2cc95fdb0,
abstract = {{Negative-pressure wound therapy (NPWT) has been used for the treatment of deep sternal wound infection (DSWI) with promising results. However, questions have been raised regarding the potential risk of right ventricle (RV) rupture during treatment. In the present study, we evaluate our clinical experience of NPWT focusing on RV rupture and major bleeding complications and its potentially negative impact on 30-day mortality during an 11-year period. Serious bleeding complications during NPWT were reviewed for 176 patients treated for DSWI between January 1999 and April 2010. The 30-day mortality following DSWI was 1.1% (2/176). Four patients (2.3%) suffered bleeding from the RV rupture during NPWT of the sternal wound (two spontaneous and two debridement related). Furthermore, two patients had debridement-related bleedings from the venous bypass grafts during wound dressing change. The very low 30-day mortality (1.1%) following DSWI supports the use of NPWT. Overall, even if major bleeding complications may occur, the risk of RV rupture seems to be outweighed by the benefit of superior infection control. However, surgical experience is recommended when debriding sternal wounds and we recommend the use of a wound dressing, such as paraffin gauze, in order to protect the RV from direct contact with the polyurethane foam. Keywords: Wound infection; Sternum; Negative-pressure wound therapy; Outcome.}},
author = {{Sjögren, Johan and Gustafsson, Ronny and Nilsson, Johan and Lindstedt Ingemansson, Sandra and Nozohoor, Shahab and Ingemansson, Richard}},
issn = {{1569-9285}},
language = {{eng}},
number = {{2}},
pages = {{117--120}},
publisher = {{European Association of Cardio-Thoracic Surgery}},
series = {{Interactive Cardiovascular and Thoracic Surgery}},
title = {{Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-days mortality in 176 patients with deep sternal wound infection.}},
url = {{http://dx.doi.org/10.1510/icvts.2010.252668}},
doi = {{10.1510/icvts.2010.252668}},
volume = {{12}},
year = {{2011}},
}