title: Hyperbaric oxygen therapy as additional treatment in deep sternal wound infections - a single center's experience.
abstract: BACKGROUND
  Deep sternal wound infection (DSWI) is one of the most serious complications after cardiac surgery procedures, observed in 5% of patients. Current standard medical therapy for DSWI includes antibiotics, surgical debridement, resuturing or negative pressure wound therapy (NPWT). Unfortunately, in some cases these methods are insufficient, and additional therapeutic options are needed.
  
  
  OBJECTIVE
  To assess the effects and usefulness of additional hyperbaric oxygen therapy (HBO2) in patients with DSWI after cardiac surgery procedures.
  
  
  METHODS
  A retrospective analysis of 10 patients after cardiac surgery who developed DSWI in the period 2010-2012 was performed. After 3 months of ineffective conventional therapy including targeted antibiotic, surgical sternal debridement and NPWT, patients were qualified for additional HBO2 therapy. A total of 20 sessions of HBO2 therapy were performed, each 92 minutes long.
  
  
  RESULTS
  After 4 weeks of HBO2 treatment, 7 patients presented complete wound healing with fibrous scar formation. One patient was qualified for the another cycle of HBO2 therapy with 20 additional sessions, and complete wound healing was observed. In 2 cases, after 5 and 19 sessions, HBO2 was interrupted because of improper qualifications.
  
  
  CONCLUSIONS
  The HBO2 as an additional therapy in DSWI was successful in 80% of cases, and no complications were observed. However, due to the small number of published studies with a small number of patients, randomized, clinical trials are needed to assess the clinical results of HBO2 in DSWI after cardiac surgery procedures.
authors: Department of Cardiovascular Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors: Radosław
authors: R
authors: Litwinowicz
authors: Department of Cardiovascular Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors: Magdalena
authors: M
authors: Bryndza
authors: Burns and Plastic Surgery, Centre of Malopolska, Ludwik Rydygier Memorial Hospital, Krakow, Poland.
authors: Anna
authors: A
authors: Chrapusta
authors: Burns and Plastic Surgery, Centre of Malopolska, Ludwik Rydygier Memorial Hospital, Krakow, Poland.
authors: Ewa
authors: E
authors: Kobielska
authors: Department of Cardiovascular Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors: Bogusław
authors: B
authors: Kapelak
authors: Department of Cardiovascular Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
authors: Grzegorz
authors: G
authors: Grudzień
keywords: deep sternal wound infection; hyperbaric oxygen therapy