Sternal stability at different negative pressures during vacuum-assisted closure therapy.

Area of Science:

• Biomedical Engineering
• Surgical Research
• Wound Healing

Background:

• Vacuum-assisted closure (VAC) is a standard treatment for poststernotomy mediastinitis.
• Assessing sternal stability under VAC therapy is crucial for patient recovery.

Purpose of the Study:

• To evaluate sternal stability during vacuum-assisted closure (VAC) application.
• To compare the effects of varying negative pressures on sternal stability in a porcine model.

Main Methods:

• A porcine model with median sternotomy was used.
• Steel wires and a traction device measured sternal diastasis.
• VAC therapy was applied at pressures ranging from -50 to -200 mm Hg.

Main Results:

• Sternal stability improved significantly at -75 mm Hg compared to an open-chest state.
• Similar sternal stability was observed at -75, -125, and -175 mm Hg.
• High negative pressures (> -150 mm Hg) combined with high lateral force increased risks of foam separation, air leakage, and organ rupture.

Conclusions:

• Low negative pressures (-50 to -100 mm Hg) provide comparable sternal stabilization to higher pressures.
• Lower VAC pressures are safer, minimizing risks of adverse events like air leakage or organ rupture.