title: Vacuum-assisted closure system in newborns after cardiac surgery.
abstract: OBJECTIVE
  To analyze the effectiveness and the results of the use of a vacuum-assisted closure (VAC) system for the treatment of complex sternal wounds in newborns after cardiac surgery.
  
  
  METHODS
  From May 2008 until December 2012, six patients developed post-sternotomy wound problems (large defects of epithelialization or mediastinitis), which were treated with a VAC system. Median age at the time of institution of VAC was 24.5 days (range 16 to 65 days). Median time of treatment was 14 days (range 3 to 42 days).
  
  
  RESULTS
  All patients were newborns and all underwent delayed sternal closure after cardiac surgery. The indications for using the VAC system were: mediastinitis in two patients (33.3%) and impairment of healing without signs of infection in four (66.7%). All children after VAC therapy achieved healing of the sternal wound. VAC therapy was started with high negative pressures (-125 mmHg) continuously then switched to an intermittent modality in all patients.
  
  
  CONCLUSIONS
  VAC system with high negative pressure is safe, effective, and is a well-tolerated therapy in newborns with complex sternal wounds.
authors.affiliation: Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Filippelli
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Perri
authors.forename: Gianluca
authors.initials: G
authors.lastname: Brancaccio
authors.forename: Francesca G
authors.initials: FG
authors.lastname: Iodice
authors.forename: Sonia B
authors.initials: SB
authors.lastname: Albanese
authors.forename: Eugenio
authors.initials: E
authors.lastname: Trimarchi
authors.forename: Adriano
authors.initials: A
authors.lastname: Carotti
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008480:Mediastinitis / Q000628:therapy*; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011183:Postoperative Complications / Q000628:therapy*; D056346:Sternotomy; D013529:Surgical Wound Dehiscence / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing