Use of improvised vaccum assisted suction drainage for cases of deep sternal wound infection

To devise a simple, cheap and effective improvised method of treating deep sternal wound infections (DSWI) by negative pressure obviating high cost of patented systems.

Records of ten post CABG patients operated via median sternotomy approach over a two and half year period and treated for DSWI were analysed. Sterile foam with drain was placed in the wound, which was covered with Ioban (Steridrape), the drain being connected to a suction unit maintaining 100mmHg pressure (<$12 cost).

Ten (10) patients of DSWI were managed with this therapy. Mean age was 60.4 years. Pseudomonas found in 1 (10%), Acinetobacter and Pseudomonas in 1 (10%) with Escherichia coli in 1 (10%). Five (50%) patients had diabetes mellitus. Mean hospitalisation period was 43 days. Seven (70%) patients underwent secondary suturing. Two (22%) patients had relapse, which was managed with dressings and secondary intention suturing. One patient who underwent a muscle flap cover had major recurrence with multiple sinuses. Excellent wound healing in 9 (90%) patients with no (0%) 90-day mortality. Improvised components can be safely employed to provide effective negative pressure therapy for DSWI with excellent results.