title: Can post-sternotomy mediastinitis be prevented by a closed incision management system?
abstract: Post-sternotomy mediastinitis is a serious complication after cardiothoracic surgery and contribute significantly to post-operative morbidity, mortality, and healthcare costs. Negative pressure wound therapy is today's golden standard for post-sternotomy mediastinitis treatment. A systematic literature search was conducted at PubMed until October 2012 to analyse whether vacuum-assisted closure technique prevents mediastinitis after clean surgical incisions closure. Today's studies showed reduction of post-sternotomy mediastinitis including a beneficial socio-economic impact. Current studies, however included only high-risk patients, hence furthermore, larger randomised controlled trials are warranted to clarify the benefit for using surgical incision vacuum management systems in the general patient population undergoing sternotomy and clarify risk factor interaction.
authors.affiliation: Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Germany.
authors.forename: Pascal M
authors.initials: PM
authors.lastname: Dohmen
authors.affiliation: Department of Cardiothoracic Surgery, Isala Klinieken Zwolle, The Netherlands.
authors.forename: Thanasie
authors.initials: T
authors.lastname: Markou
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden.
authors.forename: Richard
authors.initials: R
authors.lastname: Ingemansson
authors.affiliation: Department of Cardiothoracic Surgery, University Clinic Münster, Germany.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Rotering
authors.affiliation: Department of Cardiothoracic Surgery, University Medical Center Groningen, The Netherlands.
authors.forename: Jean M
authors.initials: JM
authors.lastname: Hartman
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus University Rotterdam, The Netherlands.
authors.forename: René
authors.initials: R
authors.lastname: van Valen
authors.affiliation: Department of Cardiothoracic Surgery, Erasmus University Rotterdam, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: Brunott
authors.affiliation: Institute of Hygiene and Environmental Medicine, University Medicine Greifswald, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Kramer
authors.affiliation: Department of Cardiothoracic Surgery, Academic Medical Center Amsterdam, The Netherlands.
authors.forename: Patrique
authors.initials: P
authors.lastname: Segers
keywords: cardiothoracic surgery; closed incision management; incisional negative pressure therapy; negative pressure wound therapy (NPWT); surgical site infection; surgical wounds