The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study

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Abstract

BACKGROUND AND AIMS: Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi-d) in the treatment of DSWI.

METHODS: We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi-d. The NPWTi-d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3-min dwell time.

RESULTS: The NPWTi-d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in-hospital mortality was 8.2%, with no significant differences between the two groups (p = 1).

CONCLUSION: NPWTi-d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi-d in the control of infection and biofilm as well as in wound healing.

Details

Original languageEnglish
Article numbere1430
JournalHealth Science Reports
Volume6
Issue number7
Publication statusPublished - Jul 2023
Peer-reviewedYes

External IDs

ORCID /0000-0003-4633-2695/work/145698739
PubMed 37465238
PubMedCentral PMC10350553

Keywords

ASJC Scopus subject areas

Keywords

  • cardiac surgery, instillation, negative pressure wound therapy, surgical wound infection, wound healing

Library keywords