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Can Drainage Using a Negative-Pressure Wound Therapy Device Replace Traditional Sample Collection Methods?

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A new mediastinal fluid collection device improved microorganism detection in patients with deep sternal wound infection (DSWI) undergoing negative-pressure wound therapy (NPWT). This advancement reduced undetected pathogens, enhancing DSWI diagnosis and treatment effectiveness.

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Area of Science:

  • Medical Microbiology
  • Wound Care
  • Infectious Diseases

Background:

  • Deep sternal wound infection (DSWI) poses a significant challenge, particularly in patients undergoing negative-pressure wound therapy (NPWT).
  • Traditional methods for collecting mediastinal fluid in these patients have limitations in accurately detecting microorganisms.
  • A novel collection device was introduced in 2015 to address these diagnostic challenges.

Purpose of the Study:

  • To evaluate the impact of a new mediastinal fluid collection device on microorganism detection rates in patients with DSWI under NPWT.
  • To compare the efficacy of the new device against traditional methods for identifying pathogens in wound infections.
  • To determine if the new device could improve diagnostic accuracy and reduce the incidence of DSWI with undetected pathogens.

Main Methods:

  • A retrospective study comparing microorganism detection rates before and after the introduction of a new collection device (ESwab™).
  • Samples were collected using traditional methods (reticulated polyurethane sponge, swab, blood culture) from 2013-2014 (n=23 patients).
  • In 2015, samples were collected using the ESwab™ device and blood culture from mediastinal fluid and NPWT drainage (n=17 patients).
  • Statistical analysis (Fisher exact test) was used to compare pathogen detection rates.

Main Results:

  • The introduction of the new collection device led to an overall increase in microorganism detection to 46.7%.
  • Traditional methods failed to detect pathogens in 30.4% of patients during 2013-2014.
  • The new approach improved microorganism detection by 10.4% and reduced DSWI with undetected pathogens to 17.6% (p<0.01).

Conclusions:

  • Mediastinal fluid collected directly from the wound and NPWT device using the new ESwab™ system is the most representative specimen for diagnosing wound infections.
  • The NPWT device may potentially replace other biologic sampling devices due to the strong correlation in microorganism detection.
  • This improved diagnostic capability aids in timely and effective management of deep sternal wound infections.