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Introduction:
Median sternotomy is the most preferred approach in heart surgery. Post-sternotomy mediastinitis is a catastrophic and potentially life-threatening complication with an incidence rate of 0.15% to 5%, and its overall mortality rate reaches 47%. In this study, we aimed to compare the results of vacuum-assisted closure technique and the...
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Context 1
... (Table 6). There were significant differences between the two groups according to the surgical wound-healing procedures performed ( Table 7). The number of sternal closure procedures with standard rewiring after wound-healing was significantly higher in the VAC group (94.23%) than in the CoT group (72.58%) (P=0.005). ...Similar publications
Minimally invasive methods continue to become increasingly common in cardiac surgery. In particular, the utilization of thoracotomy in multi-vessel coronary bypass grafting and valve surgery has accelerated, but sternotomy is still applied in combined pathologies. A 76-year-old male patient underwent multi-vessel coronary artery bypass grafting and...
Citations
... To overcome these issues, Obdeijn et al. 14 15,16 Despite the availability of research on the efficacy of NPWT and traditional standard treatments, there is a lack of specific studies comparing their effectiveness in Asian populations. Thus, our study aimed to address this gap and investigate the impact of NPWT on patients with PSM. ...
... 23 reduced reinfection rate, and decreased early mortality. 29 Akbayrak et al., 15 in a recent study, found statistically significant reductions in the total treatment duration, time from diagnosis to negative culture, hospitalization duration, and in-hospital mortality in their NPWT group as compared with the CoT group. However, our study has presented conflicting findings, and we need a larger sample size to gain a clearer understanding of the indication of NPWT and relationship between mortality and morbidity in patients with PSM. ...
Introduction
Poststernotomy mediastinitis (PSM) is a critical and life‐threatening complication that can arise after cardiac surgery. The aim of this study was to evaluate and compare the outcomes of negative pressure wound therapy (NPWT) and conventional methods in the management of mediastinitis following heart surgery with a focus on Asian populations.
Methods
For this retrospective study, we included and evaluated a total of 34 patients who had undergone cardiac operations between January 2011 and September 2021 and developed PSM. The patients were divided into two groups, the NPWT group (n = 16, 47.1%) and the conventional treatment group (n = 18, 52.9%), and compared.
Results
The two groups showed no significant differences in terms of patient characteristics, PSM wound classification based on the El Oakley classification, and wound closure methods, but there was a higher incidence of diabetes mellitus in the NPWT group. With regard to mediastinal cultures, a higher prevalence of Staphylococcus epidermidis was observed in the NPWT group. However, we found no significant differences between the two groups regarding the time interval from diagnosis to wound closure, hospitalization duration, and re‐exploration rate. Notably, the NPWT group exhibited a significantly higher in‐hospital mortality rate than the conventional treatment group (p = 0.024).
Conclusions
Our findings suggest that the use of NPWT might not lead to improved medical outcomes for patients with PSM when compared to conventional treatment methods. As a result, it becomes imperative to exercise great care when choosing patients for NPWT. To obtain more definitive and conclusive results and identify the most appropriate cases for NPWT, conducting larger randomized clinical trials is necessary.
