title: Role of vacuum in methicillin-resistant deep sternal wound infection.
abstract: Between January 2002 and January 2009, 39 patients with post-cardiotomy staphylococcal deep sternal wound infection were treated primarily by a vacuum-assisted closure method (group A). Results were compared with those of 30 patients with staphylococcal deep sternal wound infection who received closed mediastinal irrigation with antibiotics (group B). The prevalence of methicillin-resistance was similarly high in both groups (64.1% in A, 56.7% in B). One group B patient died during treatment. The median healing time was significantly shorter at 13 days in group A (mean, 13.5 +/- 3.2 days) compared to 18 days (mean, 21.2 +/- 16.4 days) in group B. Deep sternal wound infection did not recur after vacuum treatment, while 7 (24%) patients in group B suffered a recurrence. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 +/- 11.3 days vs. median, 45 days; mean, 49.2 +/- 19.3 days). The significantly shorter healing time with vacuum-assisted closure was confirmed in both methicillin-sensitive (12 vs. 17 days) and methicillin-resistant infections (14 vs. 21 days). Hospital stay remained significantly shorter in group A (35 vs. 46 days) when only methicillin-resistant deep sternal wound infection was considered.
authors: Department of Cardiothoracic Sciences, Second University of Naples, V Monaldi Hospital, Italy.
authors: Marisa
authors: M
authors: De Feo
authors: Mariano
authors: M
authors: Vicchio
authors: Gianantonio
authors: G
authors: Nappi
authors: Maurizio
authors: M
authors: Cotrufo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006801:Humans; D007558:Italy; D007902:Length of Stay; D008480:Mediastinitis / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D054843:Negative-Pressure Wound Therapy; D012008:Recurrence; D056346:Sternotomy / Q000009:adverse effects* / Q000401:mortality; D013530:Surgical Wound Infection / Q000382:microbiology / Q000401:mortality / Q000628:therapy*; D007507:Therapeutic Irrigation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents