Vacuum-assisted Closure in the Treatment of Wound Dehiscence after Thoracic and Cardiovascular Surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YU Hongquan , YANG Xueyong , LI Bing

Department of Cardiothoracic Surgery, Affiliated Hospital of the Logistics University of CAPF, Tianjin 300162, P. R. China;;
Email：hongquanyu@hotmail. com;

Corresponding author：

Keywords：

Thoracic wound dehiscence; Wound infection; Vacuum assisted closure; Surgery

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Abstract： Objective To introduce the early experience of using vacuum-assisted closure （VAC） in the treatment of wound dehiscence after thoracic and cardiovascular surgery. Methods This report retrospective1y analyzed the clinical data of 12 patients who underwent VAC in the treatment of wound dehiscence after thoracic and cardiovascular surgery in the Affiliated Hospital of the Logistics University of CAPF between October 2010 and October 2011. There were 7 male patients and 5 female patients with their mean age of 64.3 years （ranging from 39 to 80 years）. All patients underwent operation via median sternotomy or lateral thoracic incision. All the wound dehiscence was deep to sternum or rib. After debridement of necrotic tissue, the wound surfaces were covered with VAC sponges, and intermittent negative pressure therapy was used. The VAC sponges were changed every 7-10 days. Results All the patients underwent an average of 2 times to change the VAC sponges during VAC treatment. After VAC treatment, the edema around the surgical wounds gradually disappeared, and the granulation tissue was refreshed. The overall conditions of all the patients were improved. The patients could leave their bed, walk in the ward, and look after themselves. Antibiotic treatment was no longer used. The residents checked up the negative pressure system every day to see whether it worked well. The patients were no longer afraid of changing dressing and pain every day. All the patients were healed, discharged from the hospital and followed up at outpatient department for a mean time of 7 months. Their wounds all healed well during follow-up. Conclusion VACsystem is easy to use. It can facilitate the healing of wound dehiscence quickly, decrease the inflammatory reaction of local wound and the body, and shorten the rehabilitation time. It’s also helpful to reduce the residents’ work load. It is recommended in the treatment of wound dehiscence after thoracic and cardiovascular surgery.

Citation： YU Hongquan,YANG Xueyong,LI Bing,et al.. Vacuum-assisted Closure in the Treatment of Wound Dehiscence after Thoracic and Cardiovascular Surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(3): 280-282. doi: Copy

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2.	Crabtree TD， Codd JE， Fraser VJ， et al. Multivariate analysis of risk factors for deep and superficial sternal infection after coronary artery bypass grafting at a tertiary care medical center. Semin Thorac Cardiovasc Surg， 2004， 16 （1）： 53-61.
3.	Sarr MG， Gott VL， Townsend TR. Mediastinal infection after cardiac surgery. Ann Thorac Surg， 1984， 38 （4）： 415-423.
4.	毛小泉，谢文扬. 感染伤口愈合过程中负压引流对成纤维细胞的影响. 广西医学， 2009， 31 （7）：924- 926.
5.	阿玛德，蔡林，朱晓彬，等. 不同负压值的封闭式引流对猪背软组织创面中绿脓杆菌生长的影响. 武汉大学学报（医学版）， 2009， 30 （3）：386-389.
6.	Tang AT， Okri SK， Haw MP. Vacuum-assisted closure to treat deep sternal wound infection following cardiac surgery. J Wound Care， 2000， 9 （5）： 229-230.
7.	Hersh RE， Kaza AK， Long SM， et al. A technique for the treatment of sternal infections using the Vacuum Assisted Closure device. Heart Surg Forum， 2001， 4 （3）： 211-215.
8.	Sjögren J， Gustafsson R， Nilsson J， et al. Clinical outcome after poststernotomy mediastinitis： vacuum-assisted closure versus conventional treatment. Ann Thorac Surg， 2005， 79 （6）： 2049-2055.
9.	Agarwal JP， Ogilvie M， Wu LC， et al. Vacuum-assisted closure for sternal wounds： a first-line therapeutic management approach. Plast Reconstr Surg， 2005， 116 （4）： 1035-1040.
10.	朱礼霞，蒋琪霞. 负压封闭辅助伤口闭合技术的研究进展.医学研究生学报， 2010， 23 （6）：658-661.
11.	World Union of Wound Healing Societies （WUWHS）. Principles of best practice：vacuum assisted closure， recommendations for use. London： MEP Ltd， 2008. 1-20.

1. 　Eklund AM， Lyytikäinen O， Klemets P， et al. Mediastinitis after more than 10 000 cardiac surgical procedures. Ann Thorac Surg， 2006， 82 （5）： 1784-1789.
2. 　Crabtree TD， Codd JE， Fraser VJ， et al. Multivariate analysis of risk factors for deep and superficial sternal infection after coronary artery bypass grafting at a tertiary care medical center. Semin Thorac Cardiovasc Surg， 2004， 16 （1）： 53-61.
3. 　Sarr MG， Gott VL， Townsend TR. Mediastinal infection after cardiac surgery. Ann Thorac Surg， 1984， 38 （4）： 415-423.
4. 　毛小泉，谢文扬. 感染伤口愈合过程中负压引流对成纤维细胞的影响. 广西医学， 2009， 31 （7）：924- 926.
5. 　阿玛德，蔡林，朱晓彬，等. 不同负压值的封闭式引流对猪背软组织创面中绿脓杆菌生长的影响. 武汉大学学报（医学版）， 2009， 30 （3）：386-389.
6. 　Tang AT， Okri SK， Haw MP. Vacuum-assisted closure to treat deep sternal wound infection following cardiac surgery. J Wound Care， 2000， 9 （5）： 229-230.
7. 　Hersh RE， Kaza AK， Long SM， et al. A technique for the treatment of sternal infections using the Vacuum Assisted Closure device. Heart Surg Forum， 2001， 4 （3）： 211-215.
8. 　Sjögren J， Gustafsson R， Nilsson J， et al. Clinical outcome after poststernotomy mediastinitis： vacuum-assisted closure versus conventional treatment. Ann Thorac Surg， 2005， 79 （6）： 2049-2055.
9. 　Agarwal JP， Ogilvie M， Wu LC， et al. Vacuum-assisted closure for sternal wounds： a first-line therapeutic management approach. Plast Reconstr Surg， 2005， 116 （4）： 1035-1040.
10. 　朱礼霞，蒋琪霞. 负压封闭辅助伤口闭合技术的研究进展.医学研究生学报， 2010， 23 （6）：658-661.
11. 　World Union of Wound Healing Societies （WUWHS）. Principles of best practice：vacuum assisted closure， recommendations for use. London： MEP Ltd， 2008. 1-20.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Vacuum-assisted Closure in the Treatment of Wound Dehiscence after Thoracic and Cardiovascular Surgery

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