Can wound desiccation be averted during cardiac surgery? An experimental study.
During cardiac surgery the wound is exposed to desiccation, especially as a result of operating room ventilation and the insufflation of dry carbon dioxide (CO(2)) for de-airing. We compared the gas humidity and desiccation rates in an in vitro model of a cardiothoracic wound during these conditions and during insufflation of humidified CO(2). To assess the influence of flow velocity, CO(2) was insufflated at 10 L/min via two devices, a standard open-ended tube and a low-velocity gas diffuser. The treatment arms were compared with a control without insufflation. When insufflated via the open-ended tube the humidity in the model was almost equal to the control, both with dry and humidified CO(2). However, the total desiccation rate was more rapid than the control (P < 0.001), especially in the area exposed to the gas jet where the desiccation rate was three times more rapid (P < 0.001). With the gas diffuser, dry CO(2) caused almost zero humidity and a desiccation rate that was almost equal to the control. Humidified CO(2) increased humidity in comparison with the control (P < 0.001) and decreased the desiccation rate by >90% (P < 0.001). Humidified CO(2) may be used to avert desiccation of the cardiothoracic wound. The humidified gas is effective only when delivered via a low-velocity outlet device.
Persson
Mikael
M
Division of Medical Engineering, Department of Laboratory Medicine, and Department of Cardiothoracic Surgery & Anesthesiology; Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
van der Linden
Jan
J
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003890:Desiccation; D006801:Humans; D006813:Humidity; D007327:Insufflation; D008953:Models, Anatomic; D009068:Movement; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D013396:Suction; D013696:Temperature