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Hyperbaric oxygen therapy as additional treatment in deep sternal wound infections - a single center's experience
Radosław Litwinowicz1, Magdalena Bryndza1, Anna Chrapusta2
1Department of Cardiovascular Surgery and Transplantation, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
Introduction:
Deep sternal wound infection (DSWI) is one of the most serious complications after cardiac surgery procedures, observed in 5% of patients. Current standard medical therapy for DSWI includes antibiotics, surgical debridement, resuturing or negative pressure wound therapy (NPWT). Unfortunately, in some cases these methods are insufficient, and additional therapeutic options are needed.
Aim:
To assess the effects and usefulness of additional hyperbaric oxygen therapy (HBO2) in patients with DSWI after cardiac surgery procedures.
Material And Methods:
A retrospective analysis of 10 patients after cardiac surgery who developed DSWI in the period 2010-2012 was performed. After 3 months of ineffective conventional therapy including targeted antibiotic, surgical sternal debridement and NPWT, patients were qualified for additional HBO2 therapy. A total of 20 sessions of HBO2 therapy were performed, each 92 minutes long.
Results:
After 4 weeks of HBO2 treatment, 7 patients presented complete wound healing with fibrous scar formation. One patient was qualified for the another cycle of HBO2 therapy with 20 additional sessions, and complete wound healing was observed. In 2 cases, after 5 and 19 sessions, HBO2 was interrupted because of improper qualifications.
Conclusions:
The HBO2 as an additional therapy in DSWI was successful in 80% of cases, and no complications were observed. However, due to the small number of published studies with a small number of patients, randomized, clinical trials are needed to assess the clinical results of HBO2 in DSWI after cardiac surgery procedures.
Insights
Hyperbaric oxygen therapy (HBO2) shows promise as an additional treatment for deep sternal wound infections (DSWI) after cardiac surgery. This therapy successfully healed 80% of patients with DSWI, indicating its potential benefit.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Hyperbaric Medicine
Background:
- Deep sternal wound infection (DSWI) is a severe complication post-cardiac surgery, affecting 5% of patients.
- Standard treatments like antibiotics, debridement, and negative pressure wound therapy (NPWT) are not always sufficient.
Purpose of the Study:
- To evaluate the efficacy and utility of adjunctive hyperbaric oxygen therapy (HBO2) for DSWI patients.
Main Methods:
- Retrospective analysis of 10 cardiac surgery patients with DSWI treated between 2010-2012.
- Patients received HBO2 therapy after 3 months of ineffective conventional treatment (antibiotics, debridement, NPWT).
- A total of 20 sessions of HBO2 (92 minutes each) were administered.
Main Results:
- Complete wound healing with fibrous scarring was observed in 70% (7/10) of patients after 4 weeks of HBO2.
- One additional patient achieved complete healing after a second cycle of HBO2.
- HBO2 therapy was discontinued in 20% (2/10) of cases due to ineligibility.
Conclusions:
- Adjunctive HBO2 therapy demonstrated an 80% success rate in treating DSWI with no observed complications.
- Further randomized clinical trials are necessary to confirm these findings due to the limited sample size.
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