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Can post-sternotomy mediastinitis be prevented by a closed incision management system?
Pascal M Dohmen1, Thanasie Markou2, Richard Ingemansson3
1Department of Cardiac Surgery, Heart Center Leipzig, University of Leipzig, Germany.
GMS Hygiene and Infection Control
|October 7, 2014
Summary
Negative pressure wound therapy, a treatment for post-sternotomy mediastinitis, shows promise in reducing complications and costs. Further research is needed to confirm benefits in all patients undergoing sternotomy.
Area of Science:
- Medical research
- Surgical complications
- Wound management
Background:
- Post-sternotomy mediastinitis is a severe complication following cardiothoracic surgery.
- It significantly increases patient morbidity, mortality, and healthcare expenses.
- Negative pressure wound therapy is the current standard treatment for this condition.
Purpose of the Study:
- To systematically evaluate the effectiveness of vacuum-assisted closure (VAC) in preventing mediastinitis after clean sternotomy incisions.
- To analyze the socio-economic impact of VAC in managing post-sternotomy complications.
Main Methods:
- A systematic literature search was performed using PubMed up to October 2012.
- Studies focusing on vacuum-assisted closure for preventing mediastinitis after clean surgical incisions were analyzed.
Main Results:
- Existing studies indicate that vacuum-assisted closure can reduce the incidence of post-sternotomy mediastinitis.
- A beneficial socio-economic impact was observed in the included studies.
- However, current evidence is primarily based on high-risk patient populations.
Conclusions:
- Vacuum-assisted closure demonstrates potential in preventing post-sternotomy mediastinitis and offers socio-economic advantages.
- Larger, randomized controlled trials are necessary to establish the benefits of surgical incision vacuum management systems for the general sternotomy patient population.
- Further research should also clarify the interaction of risk factors with VAC efficacy.
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