Sternal wound complications: results of routine use of negative pressure wound therapy
Rev. bras. cir. cardiovasc
;
35(1): 50-57, Jan.-Feb. 2020. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1092468
ABSTRACT
Abstract Introduction:
Negative pressure wound therapy (NPWT) has significantly improved outcomes in individuals with superficial and deep sternal wound dehiscence (SWD). We report our experience with NPWT to evaluate factors influencing effectiveness, duration of treatment and postoperative hospital stay.Methods:
We reviewed 92 patients with postoperative SWD following a median sternotomy. Patients were divided into 2 groups those with a superficial SWD (Group 1; 72, 78%) and those with a deep SWD (Group 2; 20, 28%). Group 1 was further divided into 3 subgroups based on NPWT duration.Results:
In both groups, none of the preoperative characteristics examined showed a significant association with longer NPWT duration. In Group 2, there was a trend for postoperative bleeding and neurological complications to be associated with longer treatment duration. In the entire series, staph infection resulted a weak predictor of NPWT duration. In each Group 1 subgroup and in Group 2, treatment days were compared with duration of hospitalization until discharge. Mean post-NPWT hospital stay was 6 days in subgroup 1, 12 days in subgroup 2 and 20 days in subgroup 3 (P<0.0001). At a median 3-year follow-up, there were 4 late deaths, none related to wound complications. No cases of SWD recurrence were observed.Conclusion:
Our results confirm the effectiveness of NPWT in SWD management, while excessive treatment duration might have a negative impact on the length of hospital stay. Further studies are needed to define an optimal use of NPWT protocol.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Tratamento de Ferimentos com Pressão Negativa
Tipo de estudo:
Guia de Prática Clínica
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
Cirurgia Geral
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Itália
Instituição/País de afiliação:
University Hospital/IT
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