Assessment of vacuum-assisted closure therapy on the wound healing process in cardiac surgery.
Postoperative deep sternal wound infection (DSWI) is a serious complication in cardiac surgery (1-5% of patients) with high mortality and morbidity rates. Vacuum-assisted closure (VAC) therapy has shown promising results in terms of wound healing process, postoperative hospital length of stay and lower in-hospital costs. The aim of our retrospective study is to report the outcome of patients with DSWI treated with VAC therapy and to assess the effect of contributory risk factors. Data of 52 patients who have been treated with VAC therapy in a single institution (study period: September 2003-March 2012) were collected electronically through PAtient Tracking System PATS and statistically analysed using SPSS version 20. Of the 52 patients (35 M: 17 F), 88·5% (n = 46) were solely treated with VAC therapy and 11·5% (n = 6) had additional plastic surgical intervention. Follow-up was complete (mean 33·8 months) with an overall mortality rate of 26·9% (n = 14) of whom 50% (n = 7) died in hospital. No death was related to VAC complications. Patient outcomes were affected by pre-operative, intra-operative and postoperative risk factors. Logistic EUROscore, postoperative hospital length of stay, advanced age, chronic obstructive pulmonary disease (COPD) and long-term corticosteroid treatment appear to be significant contributing factors in the long-term survival of patients treated with VAC therapy.
School of Medicine, Cardiff University, Cardiff, UK.|Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, UK.
Agamemnon
A
Pericleous
Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, UK.
Georgios
G
Dimitrakakis
Department of Statistics, University of Oxford, Oxford, UK.
Renos
R
Photiades
Department of Cardiothoracic Surgery, University Hospital of Wales, Cardiff, UK.
Ulrich O
UO
von Oppell
D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D054843:Negative-Pressure Wound Therapy; D012189:Retrospective Studies; D013249:Sternum; D013530:Surgical Wound Infection; D016896:Treatment Outcome; D014945:Wound Healing
Cardiac surgery; Risk factors; Sternal wound infection; VAC dressing; Wound healing