Efficacy of vacuum-assisted closure therapy on rehabilitation during the treatment for surgical site infection after cardiovascular surgery.
OBJECTIVE
Surgical site infection (SSI) after cardiovascular procedures is a severe complication, potentially leading to high morbidity and mortality. In addition, during the treatment of SSI, rehabilitation is delayed, which can severely impair postoperative recovery. The aim of this study was to assess the effect of vacuum-assisted closure (VAC) therapy on rehabilitation during the treatment of SSI after cardiovascular surgery.


METHODS
From January 2008 to March 2015, 10 patients underwent VAC therapy for SSI after cardiovascular operations. The patient characteristics, duration of VAC therapy, time interval from the implementation of VAC to physical therapy (PT) (T1), ambulation (T2) and walking (T3), functional independent measure (FIM), and maximum consecutive walking capacity (MCWC) were retrospectively analyzed.


RESULTS
Nine patients underwent mid-sternal incision and one patient underwent thoraco-abdominal incision. The mean time interval from the beginning of VAC therapy to PT, ambulation, and walking was 0.38 ± 0.50, 0.63 ± 0.71, and 1.38 ± 1.86 days, respectively. The average FIM was 84.5 ± 14.0 at the beginning of VAC therapy and 106.7 ± 18.5 at the end of VAC therapy (P = 0.000494). On average, MCWC was 52.3 ± 54.6 m at the installation of VAC therapy and 189.7 ± 152.8 m at the completion of VAC therapy (P = 0.0169). FIM and MCWC improvement rate was better in VAC group than non-VAC group although these data are not suitable for statistical analysis because of a small sample size.


CONCLUSIONS
Although further studies are warranted, VAC therapy may have a role in facilitating rehabilitation and improving the prognosis of SSI cases after major cardiovascular operations.
Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan. yoshimoto0401@hotmail.co.jp.
Akihiro
A
Yoshimoto
Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan.
Takafumi
T
Inoue
Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan.
Masayuki
M
Fujisaki
Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan.
Sei
S
Morizumi
Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan.
Yoshihiro
Y
Suematsu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D012189:Retrospective Studies; D056346:Sternotomy; D013530:Surgical Wound Infection / Q000382:microbiology / Q000534:rehabilitation* / Q000601:surgery*; D013997:Time Factors; D016138:Walking
Cardiovascular surgery; Rehabilitation; Surgical site infection; VAC treatment