title: Tremendous bleeding complication after vacuum-assisted sternal closure.
abstract: Vacuum-assisted closure (VAC) of complex infected wounds has recently gained popularity among various surgical specialties. The system is based on the application of negative pressure by controlled suction to the wound surface. The effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation are proved. No contraindications for the use in deep sternal wounds in cardiac surgery are described. In our case report we illustrate a scenario were a patient developed severe bleeding from the ascending aorta by penetration of wire fragments in the vessel. We conclude that all free particles in the sternum have to be removed completely before negative pressure is used.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany. cardiac.surgeon@dr-kiessling.com
authors.forename: Arndt H
authors.initials: AH
authors.lastname: Kiessling
authors.forename: Andreas
authors.initials: A
authors.lastname: Lehmann
authors.forename: Frank
authors.initials: F
authors.lastname: Isgro
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000601:surgery; D056346:Sternotomy