Topical negative pressure therapy in wounds after cardiothoracic surgery: successful experience supported by literature.
BACKGROUND
Patients undergoing cardiothoracic surgery are at substantial risk of developing surgical site infections (SSI). SSI is not only associated with an increased morbidity but also with high mortality. Topical negative pressure therapy (TNP) is a promising method for treating surgical site defects (SSD). In recent years, we have gained a wide experience with TNP in a great variety of SSD.


METHODS
We completed a prospective follow-up report of all patients treated with TNP after cardiothoracic surgery at the Academic Medical Centre Amsterdam, a university hospital. A review of the current evidence for TNP in cardiothoracic surgery is presented.


RESULTS
Between August 2000 and March 2005, TNP was used in 105 patients in 113 SSD. As we gained more experience, we saw a decline in hospital stay ( P < 0.0001) and duration of TNP therapy. Surgical closure was performed in 62 % of patients using simple surgical (reconstructive) techniques. Therapy-related complications were rare (n = 1).


CONCLUSIONS
Based on clinical findings and supported by the research presented, the treatment modality of choice for SSD after cardiothoracic surgery is TNP.
Segers
P
P
Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. p.segers@amc.uva.nl
de Jong
A P
AP
Kloek
J J
JJ
van der Horst
C M
CM
Spanjaard
L
L
de Mol
B A
BA
D000368:Aged; D000704:Analysis of Variance; D001274:Atmospheric Pressure; D006348:Cardiac Surgical Procedures; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009779:Occlusive Dressings / Q000009:adverse effects / Q000191:economics; D011446:Prospective Studies; D013529:Surgical Wound Dehiscence / Q000453:epidemiology / Q000209:etiology; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome; D014945:Wound Healing