Document Detail


Major complications during negative pressure wound therapy in poststernotomy mediastinitis after cardiac surgery.
MedLine Citation:
PMID:  20832086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Negative pressure wound therapy is the first-line treatment modality for poststernotomy mediastinitis in many heart centers. The aim of this study was to analyze major complications and possible preventive methods during negative pressure wound therapy in patients with deep sternal wound infections. METHODS: We retrospectively analyzed 69 consecutive patients treated with negative pressure wound therapy for poststernotomy mediastinitis between June 2006 and September 2009. RESULTS: Five (7.2%) patients sustained major complications during negative pressure wound therapy. Bleeding from coronary artery venous bypass grafts was observed in 4 patients and fulminant bleeding from an infected homograft of the ascending aorta was observed in 1 patient during routine dressing changes of the negative pressure wound therapy system. CONCLUSIONS: Bleeding is the major complication during negative pressure wound therapy for poststernotomy mediastinitis. Covering the heart with several layers of paraffin gauze is a necessary protective maneuver but cannot completely prevent major complications during negative pressure wound therapy. All operative procedures, including dressing changes, should be performed in the operating room under optimal hygienic and monitoring conditions to increase the salvage rate and to guarantee optimal surgical and anesthesiologic conditions in case of negative pressure wound therapy-related complications.
Authors:
Rainer Petzina; Malin Malmsjö; Christof Stamm; Roland Hetzer
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Publication Detail:
Type:  Journal Article     Date:  2010-09-15
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  140     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-18     Completed Date:  2010-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1133-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Deutsches Herzzentrum Berlin, Berlin, Germany. petzina@web.de
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MeSH Terms
Descriptor/Qualifier:
Cardiac Surgical Procedures / adverse effects*,  mortality
Germany
Hospital Mortality
Humans
Mediastinitis / etiology,  mortality,  therapy*
Negative-Pressure Wound Therapy / adverse effects*,  mortality
Postoperative Hemorrhage / etiology*,  mortality,  surgery
Reoperation
Retrospective Studies
Sternotomy / adverse effects*,  mortality
Surgical Wound Infection / etiology,  mortality,  therapy*
Time Factors
Treatment Outcome
Wound Healing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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