ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Fleck, T. M.
Right arrow Articles by Grabenwoger, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fleck, T. M.
Right arrow Articles by Grabenwoger, M.
Related Collections
Right arrow Cardiac - other

Ann Thorac Surg 2002;74:1596-1600
© 2002 The Society of Thoracic Surgeons

Original article: cardiovascular

The vacuum-assisted closure system for the treatment of deep sternal wound infections after cardiac surgery

Tatjana M. Fleck, MDa*, Michael Fleck, CMa, Reinhard Moidl, MDa,b, Martin Czerny, MDa, Rupert Koller, MDb, Pietro Giovanoli, MDb, Michael J. Hiesmayer, MDb, Daniel Zimpfer, CMb, Ernst Wolner, MDa, Martin Grabenwoger, MDa

a Departments of Cardiothoracic Surgery, University of Vienna, Vienna, Austria
b Plastic and Reconstructive Surgery, University of Vienna, Vienna, Austria

Accepted for publication June 26, 2002.

* Address reprint requests to Dr Fleck, Department of Cardiothoracic Surgery, University of Vienna, AKH Vienna, Leitstelle 20A, Währinger Gürtel 18-20, 1090 Vienna, Austria.
e-mail: t9204604{at}hotmail.com

BACKGROUND: The VAC system (vacuum-assisted wound closure) is a noninvasive active therapy to promote healing in difficult wounds that fail to respond to established treatment modalities. The system is based on the application of negative pressure by controlled suction to the wound surface. The method was introduced into clinical practice in 1996. Since then, numerous studies proved the effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation.

METHODS: Eleven patients (5 men, 6 women) with a median age of 64.4 years (range 50 to 78 years) with sternal wound infection after cardiac surgery (coronary artery bypass grafting = 5, aortic valve replacement = 5, ascending aortic replacement = 1) were fitted with the VAC system by the time of initial surgical debridement.

RESULTS: Complete healing was achieved in all patients. The VAC system was removed after a mean of 9.3 days (range 4 to 15 days), when systemic signs of infection resolved and quantitative cultures were negative. In 6 patients (54.5%), the VAC system was used as a bridge to reconstructive surgery with a pectoralis muscle flap, and in the remaining 5 patients (45.5%), primary wound closure could be achieved. Intensive care unit stay ranged from 1 to 4 days (median 1 day). Duration of hospital stay varied from 13 to 45 days (median 30 days). In-hospital mortality was 0%, and 30-day survival was 100%.

CONCLUSIONS: The VAC system can be considered as an effective and safe adjunct to conventional and established treatment modalities for the therapy of sternal wound infections after cardiac surgery.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
L. F. Lopez Almodovar, G. Bustos, P. Lima, A. Canas, I. Paredes, and J. A. Buendia
Transverse Plate Fixation of Sternum: A New Sternal-Sparing Technique
Ann. Thorac. Surg., September 1, 2008; 86(3): 1016 - 1017.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. Petzina, M. Ugander, L. Gustafsson, H. Engblom, R. Hetzer, H. Arheden, R. Ingemansson, and M. Malmsjo
Topical negative pressure therapy of a sternotomy wound increases sternal fluid content but does not affect internal thoracic artery blood flow: Assessment using magnetic resonance imaging.
J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1007 - 1013.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
C. Schimmer, S.-P. Sommer, M. Bensch, and R. Leyh
Primary treatment of deep sternal wound infection after cardiac surgery: a survey of German heart surgery centers
Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 708 - 711.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. Lindstedt, M. Malmsjo, and R. Ingemansson
Blood Flow Changes in Normal and Ischemic Myocardium During Topically Applied Negative Pressure
Ann. Thorac. Surg., August 1, 2007; 84(2): 568 - 573.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Fleck, R. Moidl, A. Blacky, M. Fleck, E. Wolner, M. Grabenwoger, and W. Wisser
Triclosan-Coated Sutures for the Reduction of Sternal Wound Infections: Economic Considerations
Ann. Thorac. Surg., July 1, 2007; 84(1): 232 - 236.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
N. Reiss, U. Schuett, M. Kemper, A. Bairaktaris, and R. Koerfer
New Method for Sternal Closure After Vacuum-Assisted Therapy in Deep Sternal Infections After Cardiac Surgery
Ann. Thorac. Surg., June 1, 2007; 83(6): 2246 - 2247.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Gorlitzer, M. Grabenwoeger, J. Meinhart, H. Swoboda, W. Oczenski, N. Fiegl, and F. Waldenberger
Descending Necrotizing Mediastinitis Treated With Rapid Sternotomy Followed by Vacuum-Assisted Therapy
Ann. Thorac. Surg., February 1, 2007; 83(2): 393 - 396.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. Sjogren, M. Malmsjo, R. Gustafsson, and R. Ingemansson
Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm
Eur. J. Cardiothorac. Surg., December 1, 2006; 30(6): 898 - 905.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. Mokhtari, R. Petzina, L. Gustafsson, J. Sjogren, M. Malmsjo, and R. Ingemansson
Sternal stability at different negative pressures during vacuum-assisted closure therapy.
Ann. Thorac. Surg., September 1, 2006; 82(3): 1063 - 1067.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
C. H.K. Wong, S. Senewiratne, B. Garlick, and D. Mullany
Two-stage management of sternal wound infection using bilateral pectoralis major advancement flap.
Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 148 - 152.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
C. Mills and P. Bryson
The role of hyperbaric oxygen therapy in the treatment of sternal wound infection.
Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 153 - 159.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
T. Fleck, P. Simon, G. Burda, E. Wolner, and G. Wollenek
Vacuum assisted closure therapy for the treatment of sternal wound infections in neonates and small infants
Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 285 - 288.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
T. Fleck, R. Moidl, P. Giovanoli, O. Aszmann, A. Bartunek, A. Blacky, M. Grabenwoger, and E. Wolner
A conclusion from the first 125 patients treated with the vacuum assisted closure system for postoperative sternal wound infection
Interactive CardioVascular and Thoracic Surgery, April 1, 2006; 5(2): 145 - 148.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Sjogren, J. Nilsson, R. Gustafsson, M. Malmsjo, and R. Ingemansson
The Impact of Vacuum-Assisted Closure on Long-Term Survival After Post-Sternotomy Mediastinitis
Ann. Thorac. Surg., October 1, 2005; 80(4): 1270 - 1275.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
L. F. L. Almodovar, A. C. Canas, P. P. Lima Canadas, and M. C. Hernandez
Vacuum-assisted therapy with a handcrafted system for the treatment of wound infection after median sternotomy
Interactive CardioVascular and Thoracic Surgery, October 1, 2005; 4(5): 412 - 414.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Sjogren, R. Gustafsson, J. Nilsson, M. Malmsjo, and R. Ingemansson
Clinical Outcome After Poststernotomy Mediastinitis: Vacuum-Assisted Closure Versus Conventional Treatment
Ann. Thorac. Surg., June 1, 2005; 79(6): 2049 - 2055.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
U. Fuchs, A. Zittermann, B. Stuettgen, A. Groening, K. Minami, and R. Koerfer
Clinical Outcome of Patients With Deep Sternal Wound Infection Managed by Vacuum-Assisted Closure Compared to Conventional Therapy With Open Packing: A Retrospective Analysis
Ann. Thorac. Surg., February 1, 2005; 79(2): 526 - 531.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
J. Sjogren, R. Gustafsson, A. Wackenfors, M. Malmsjo, L. Algotsson, and R. Ingemansson
Effects of vacuum-assisted closure on central hemodynamics in a sternotomy wound model
Interactive CardioVascular and Thoracic Surgery, December 1, 2004; 3(4): 666 - 671.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
E. C. Douville, J. W. Asaph, R. J. Dworkin, J. R. Handy Jr, C. S. Canepa, G. L. Grunkemeier, and Y. Wu
Sternal Preservation: A Better Way to Treat Most Sternal Wound Complications After Cardiac Surgery
Ann. Thorac. Surg., November 1, 2004; 78(5): 1659 - 1664.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
W. H. Merrill, S. A. Akhter, R. K. Wolf, E. W. Schneeberger, and J. B. Flege Jr
Simplified treatment of postoperative mediastinitis
Ann. Thorac. Surg., August 1, 2004; 78(2): 608 - 612.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
R. I. Gustafsson, J. Sjogren, and R. Ingemansson
Deep sternal wound infection: a sternal-sparing technique with vacuum-assisted closure therapy
Ann. Thorac. Surg., December 1, 2003; 76(6): 2048 - 2053.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
Y. Abu-Omar, M. J. Naik, P. A. Catarino, and C. Ratnatunga
Right ventricular rupture during use of high-pressure suction drainage in the management of poststernotomy mediastinitis
Ann. Thorac. Surg., September 1, 2003; 76(3): 974 - 974.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. M. Fleck and M. Grabenwoger
Reply
Ann. Thorac. Surg., September 1, 2003; 76(3): 974 - 974.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2002 by The Society of Thoracic Surgeons.