| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2003;76:2048-2053
© 2003 The Society of Thoracic Surgeons
a Department of Cardiothoracic Surgery Heart and Lung Division, Lund University Hospital, Lund, Sweden
Accepted for publication June 25, 2003.
* Address reprint requests to Dr Gustafsson, Department of Cardiothoracic Surgery, Heart and Lung Division, Lund University Hospital, SE-221 85 Lund, Sweden.
e-mail: ronny.gustafsson{at}thorax.lu.se
BACKGROUND: Vacuum-assisted closure therapy is a novel treatment employed to aid wound healing in different areas of the body and recently also in sternotomy wounds. Aggressive vacuum-assisted closure treatment of the sternum in postoperative deep wound infection enhances sternal preservation and the rate of possible rewiring.
METHODS: The records of 40 consecutive patients with deep sternal wound infection were reviewed. Sternal bone sparing was achieved by using layers of paraffin gauze (Jelonet; Smith and Nephew Medical, Hull, UK) at the bottom of the wound in order to cover and protect visible parts of the right ventricle, lung tissue, and grafts from the sternal edges. Two separate layers of polyurethane foam (KCI, Copenhagen, Denmark) were placed so as to fit between the sternal edges and subcutaneously. A continuous negative pressure of 125 mm Hg was applied and subsequent revision was made exclusively in nongranulation areas.
RESULTS: There were no deaths during the 90 days of follow-up. Three late deaths unrelated to the infection and three subcutaneous fistulas occurred during the total follow-up period (3 to 41 months). The median duration of the vacuum-assisted closure therapy was 10 days (range, 3 to 34). The series represents a total of 474 days with the vacuum-assisted closure device without serious adverse events.
CONCLUSIONS: In our opinion this modified vacuum-assisted closure therapy is a safe and reproducible option to bridge patients with postoperative deep sternal wound infection to complete healing. Reconstruction of the sternum was achieved in all patients without the use of muscle or omental flap surgery.
This article has been cited by other articles:
|
|
 |
|
  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]
|
|
|
|
 |
|
 A. J. Poncelet, B. Lengele, B. Delaere, F. Zech, D. Glineur, J.-C. Funken, G. El Khoury, and P. Noirhomme Algorithm for primary closure in sternal wound infection: a single institution 10-year experience Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 232 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 S. G. Raja and G. A. Berg Should vacuum-assisted closure therapy be routinely used for management of deep sternal wound infection after cardiac surgery? Interactive CardioVascular and Thoracic Surgery, August 1, 2007; 6(4): 523 - 527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Vicchio, A. Amato, E. Merlino, A. Nava, M. De Feo, G. Caianiello, and M. Cotrufo Treatment of deep thoracotomy wound infection in neonatal age: A case report J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 254 - 255. [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
R. Petzina, M. Ugander, L. Gustafsson, H. Engblom, J. Sjogren, R. Hetzer, R. Ingemansson, H. Arheden, and M. Malmsjo Hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery: Assessment using magnetic resonance imaging J. Thorac. Cardiovasc. Surg., May 1, 2007; 133(5): 1154 - 1162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
U. Sartipy, U. Lockowandt, J. Gabel, L. Jideus, and G. Dellgren Cardiac rupture during vacuum-assisted closure therapy. Ann. Thorac. Surg., September 1, 2006; 82(3): 1110 - 1111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Petzina, L. Gustafsson, A. Mokhtari, R. Ingemansson, and M. Malmsjo Effect of vacuum-assisted closure on blood flow in the peristernal thoracic wall after internal mammary artery harvesting. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 85 - 89. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Doyle, S. R. Large, and F. Murphy Sternal wound dehiscence after internal mammary artery harvesting. Logical management. Part 2 Interactive CardioVascular and Thoracic Surgery, December 1, 2005; 4(6): 511 - 513. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Ford, S. Rathinam, J. E. King, and R. Vaughan Tuberculous osteomyelitis of the sternum: Successful management with debridement and vacuum assisted closure Eur. J. Cardiothorac. Surg., October 1, 2005; 28(4): 645 - 647. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
A. Wackenfors, R. Gustafsson, J. Sjogren, L. Algotsson, R. Ingemansson, and M. Malmsjo Blood Flow Responses in the Peristernal Thoracic Wall During Vacuum-Assisted Closure Therapy Ann. Thorac. Surg., May 1, 2005; 79(5): 1724 - 1730. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. De Feo INVITED COMMENTARY Ann. Thorac. Surg., May 1, 2005; 79(5): 1730 - 1731. [Full Text] [PDF]
|
|
|
|
|
|
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 | 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 |
