title: Novel technique for avoidance of pressure competition between a negative pressure wound therapy device and chest drains in the management of deep sternal wound infections.
abstract: In recent years, the use of negative pressure wound therapy (NPWT) devices has changed the way sternal wound infections are being managed. It is not uncommon for deep sternal wound infections to occur together with mediastinal or even pleural collections requiring underwater seal drainage. In these patients in whom there is a communication between the pleural and mediastinal cavities, the concomitant use of an NPWT device negates the pressure gradient within the pleural and mediastinal drains, allowing suppurative fluid to stagnate. We present a novel technique to address this limitation of NPWT devices in patients with sternal wound infections that communicate with a pleural collection.
authors.affiliation: Department of Plastic Surgery, King's College Hospital, London, UK jamesdavis1@nhs.net.
authors.forename: James S
authors.initials: JS
authors.lastname: Davis
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, UK.
authors.forename: Antonios
authors.initials: A
authors.lastname: Kourliouros
authors.affiliation: Department of Cardiothoracic Surgery, King's College Hospital, London, UK.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Deshpande
authors.affiliation: Department of Plastic Surgery, King's College Hospital, London, UK.
authors.forename: Naveen
authors.initials: N
authors.lastname: Cavale
mesh_terms: D000368:Aged; D015505:Chest Tubes; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects / Q000295:instrumentation*; D010996:Pleural Effusion / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D056346:Sternotomy / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Mediastinitis; Negative pressure wound therapy device; Pleural effusion; Sternal wound infection