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Strategic management of deep sternal wound infection using Vacuum Assisted Closure system


Mahmoud ElDegwy , Alaa Omar , Ahmed Othman Elasheery , Mohamed AbdElsalam Shaaban

Abstract

Background: Deep sternal wound infection is a very devastating complication after cardiac operations. Vacuum-assisted closure (VAC) has become an encouraging line of treatment for sternal wound infection after cardiac surgery, providing excellent, long standing result. Objectives: To assess feasibility of management of deep sternal wound infections with VAC system. Results: 107 patients (98.17 %) were treated successfully with complete healing of the wound. Two patients (1.83 %) died, the first one died of septic shock and the other of sudden ventricular tachycardia and arrest. The overall length of hospitalization was 32.2 days (range 14-68), some patients discharged and completed VAC dressing at home. The median VAC treatment time until closure was 51.1 days (range 9-110). The most common organism obtained from wound culture was MRSA in 51 patients (46.8%). VAC therapies were used as effective primary line of treatment of deep sternal wound infection (DSWI). Conclusion: VAC therapy may be considered as most effective primary modality of treatment of deep sternal wound infections and also effective adjunct to conventional treatment modalities for management of extensive and life-threatening wound infections following cardiac surgery, particularly in the presence of risk factors.



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