title: Incisional negative pressure wound therapy in reconstructive surgery of poststernotomy mediastinitis.
abstract: The efficacy of negative pressure wound therapy in the treatment of poststernotomy mediastinitis has been revealed in many reports. The present retrospective observational study examined the efficacy of incisional negative pressure wound therapy in the reconstructive surgery of poststernotomy mediastinitis. We retrospectively examined 1034 consecutive patients, who underwent median sternotomy in the period between October 2013 and September 2015. Mediastinitis developed in 21 patients (2%), who subsequently underwent surgical reconstruction. We applied incisional negative pressure wound therapy (iNPWT) after primary closure of the wound over redon drains in ten patients (iNPWT + redon group). In 11 patients, only redons were used (redons only group). We observed the time between the introduction and removal of redon drains, hospital stay until final wound closure and the rate of failure of treatment. Failure of treatment is defined as the need for further surgical reconstruction. In the iNPWT + redon group, the duration of redon drainage therapy was 6·9 ± 5·2 days versus 13·36 ± 11·58 in the redons only group. Hospital stay was 11·4 ± 8·6 versus 101·64 ± 89·2, and failure of treatment was 10% versus 45·5%, respectively. The primary results of this study appear to support the beneficial effect of iNPWT after radical wound reconstruction.
authors.affiliation: Department of Cardiac Surgery, Zala County Hospital, University of Pécs, Zalaegerszeg, Hungary.
authors.forename: Aref
authors.initials: A
authors.lastname: Rashed
authors.affiliation: Department of Cardiac Surgery, Zala County Hospital, University of Pécs, Zalaegerszeg, Hungary.
authors.forename: Magdolna
authors.initials: M
authors.lastname: Frenyo
authors.affiliation: Department of Cardiac Surgery, Zala County Hospital, University of Pécs, Zalaegerszeg, Hungary.
authors.forename: Karoly
authors.initials: K
authors.lastname: Gombocz
authors.affiliation: Department of Cardiac Surgery, University of Pécs, Pécs, Hungary.
authors.forename: Sandor
authors.initials: S
authors.lastname: Szabados
authors.affiliation: Department of Cardiac Surgery, Zala County Hospital, University of Pécs, Zalaegerszeg, Hungary.
authors.forename: Nasri
authors.initials: N
authors.lastname: Alotti
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology* / Q000601:surgery*; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D012189:Retrospective Studies; D056346:Sternotomy / Q000009:adverse effects*; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Failure of treatment; Incisional negative pressure wound therapy; Poststernotomy mediastinitis; Redon drains