[The importance of vacuum therapy in the treatment of sternal osteomyelitis from the plastic surgeons point of view].
BACKGROUND
Since its introduction in 1997 the vacuum assisted closure therapy has gained widespread and is for its indications international accepted. It is also well established in the treatment of sternal infections a dreaded complication after median sternotomy in cardiac surgery. The well known positive effects of the vacuum therapy act as a dignified cleaning procedure between debridement and plastic coverage or as a temporarily closure method if the first debridement was properly not sufficient.


METHODS
Between January 2003 and December 2005 twenty eight patients with advanced sternal infection after median sternotomy were treated by radical debridement, vacuum assisted closure therapy and definitive plastic coverage by muscle flaps. In this article three patients are exemplarily introduced.


RESULTS
In all patients a sufficient plastic coverage was achieved after radical debridement an vacuum assisted closure therapy. The patients received a pedicaled muscle flap. Stable wound condition with no signs of a recurrent sternal infection were observed in all patients.


CONCLUSIONS
Vacuum assisted closure therapy acts as a link between radical Debridement and definitive plastic coverage in prolonged sternal infection after median sternotomy. Before the invention of V.A.C.(R) dressing changes were obliged every day in patients with deep sternal infection. The V.A.C.(R) therapy reduces the frequency of this painful dressing changes significantly and on this behalf makes life more comfortable for this mostly multi-morbid patients.
Loos
B
B
Abteilung für Plastische und Handchirurgie der Friedrich-Alexander-Universität Erlangen-Nürnberg. Bernd.Loos@chir.imed.uni-erlangen.de
Kopp
J
J
Kneser
U
U
Weyand
M
M
Horch
R E
RE
D000368:Aged; D000465:Algorithms; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D010019:Osteomyelitis / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011182:Postoperative Care; D012086:Reoperation; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection; D014618:Vacuum; D014945:Wound Healing / Q000502:physiology