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Use of Negative Pressure Wound Therapy with Irrigation of Oxycholorsene in Sternal Wound Infections
Noor Malik, BS; Ravi Bamba, MD; Mary Lester, MD
Indiana University School of Medicine
2024-01-15
Presenter: Noor Malik
Affidavit:
Noor Malik
Director Name: Mary Lester
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Sternal wound infections present as a critical challenge that increase morbidity and mortality rates in patients receiving surgery. Various strategies such as sternal debridement, vacuum-assisted closure, antibiotic catheter irrigation, muscle flap techniques, have been employed to prevent sternal wound infections.
This retrospectively analysis includes patients who had cardiac surgery at our institution between 2013 and 2020. Type of cardiac surgery, number of debridements, wound management, and post-operative complications were examined.
Forty-two patients met the inclusion criteria. Common manifestations for undergoing initial cardiac surgery included coronary artery bypass graft (30/42, 71.43%) and valve disease (12/42, 28.57%). Preoperative morbidity included sternal would dehiscence (9/42, 26.19%), wound infection (23/42, 54.76%), wound drainage (4/42, 9.52%), and hemodynamic instability of the sternum (3/42, 7.14%). 40 out of 42 patients had a pectoralis flap. From those patients, 24 out of 40 patients mobilized one debridement while 16 out of 40 patients mobilized multiple debridement. A regular wound vac therapy was implemented for 31 out of 40 patients, while a VAC Veraflo therapy was implemented for 9 out of 40 patients. Postoperative complications included impaired wound healing (2/40, 5%), partial dehiscence (2/40, 5%), and a recurrent infection (3/40, 7.5%). Three patients with the VAC Veraflo (33%) also developed postoperative complications.
VAC Veraflo utilizes a negative pressure dressing with a topical antibiotic to promote wound healing. The utilization of VAC Veraflo combined with pectoralis flap closure showed no significant difference in reducing the number of postoperative complications or the amount of debridement after a sternotomy.
