The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study
Abstract Background and Aims Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi‐d) in the treatment of DSWI. Me...
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| Format: | Article |
| Language: | English |
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Wiley
2023-07-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.1430 |
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| author | Olimpiu Bota Feras Taqatqeh Florian Bönke Jörg Nowotny Klaus Matschke Kevin Bienger Adrian Dragu |
| author_facet | Olimpiu Bota Feras Taqatqeh Florian Bönke Jörg Nowotny Klaus Matschke Kevin Bienger Adrian Dragu |
| author_sort | Olimpiu Bota |
| collection | DOAJ |
| description | Abstract Background and Aims Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi‐d) in the treatment of DSWI. Methods We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi‐d. The NPWTi‐d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3‐min dwell time. Results The NPWTi‐d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in‐hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). Conclusion NPWTi‐d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi‐d in the control of infection and biofilm as well as in wound healing. |
| first_indexed | 2024-03-12T21:25:30Z |
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| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-03-12T21:25:30Z |
| publishDate | 2023-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-3d076b9cd7194e1988da6f848a13fafc2023-07-28T08:52:32ZengWileyHealth Science Reports2398-88352023-07-0167n/an/a10.1002/hsr2.1430The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort studyOlimpiu Bota0Feras Taqatqeh1Florian Bönke2Jörg Nowotny3Klaus Matschke4Kevin Bienger5Adrian Dragu6Faculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyFaculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyFaculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyFaculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyDepartment of Cardiac Surgery University Heart Center Dresden Dresden GermanyFaculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyFaculty of Medicine Carl Gustav Carus University Center for Orthopedics, Trauma and Plastic Surgery Dresden GermanyAbstract Background and Aims Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi‐d) in the treatment of DSWI. Methods We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi‐d. The NPWTi‐d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3‐min dwell time. Results The NPWTi‐d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in‐hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). Conclusion NPWTi‐d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi‐d in the control of infection and biofilm as well as in wound healing.https://doi.org/10.1002/hsr2.1430cardiac surgeryinstillationnegative pressure wound therapysurgical wound infectionwound healing |
| spellingShingle | Olimpiu Bota Feras Taqatqeh Florian Bönke Jörg Nowotny Klaus Matschke Kevin Bienger Adrian Dragu The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study Health Science Reports cardiac surgery instillation negative pressure wound therapy surgical wound infection wound healing |
| title | The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study |
| title_full | The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study |
| title_fullStr | The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study |
| title_full_unstemmed | The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study |
| title_short | The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study |
| title_sort | role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections a retrospective cohort study |
| topic | cardiac surgery instillation negative pressure wound therapy surgical wound infection wound healing |
| url | https://doi.org/10.1002/hsr2.1430 |
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