A double Dacron patch repair for right ventricle rupture during negative-pressure wound therapy of deep sternal wound infection

2020 ◽  
pp. 021849232095781
Author(s):  
Martin Simek ◽  
Andrea Steriovsky ◽  
Martin Kalab
2016 ◽  
pp. 41-73
Author(s):  
Christian Willy ◽  
Catharina Scheuermann-Poley ◽  
Marcus Stichling ◽  
Onnen Grauhan ◽  
André Lieber

2021 ◽  
pp. 145749692110433
Author(s):  
Heidi-Mari Myllykangas ◽  
Jari Halonen ◽  
Annastiina Husso ◽  
Leena T. Berg

Background and objective: Deep sternal wound infection is a feared complication of open-heart surgery. Negative pressure wound therapy has gained an important role in the treatment of deep sternal wound infection. Incisional negative pressure wound therapy has been introduced as a method to prevent wound complications after sternotomy, and lately, after flap reconstructions in the treatment of deep sternal wound infection. We aimed to study if incisional negative pressure wound therapy with PICO™ had similar beneficial effect described earlier with competing commercial devices. Methods: This study included 82 patients treated with pectoralis major muscle flap for deep sternal wound infection during the years 2006–2020. PICO group consisted of 24 patients treated with preoperative negative pressure wound therapy and postoperative incisional negative pressure wound therapy (PICO™). Two control groups included 48 patients with conventional treatment and 10 patients with preoperative negative pressure wound therapy only. Results: In the PICO group, the complication rate declined from 50.0% to 33.30%, major complication rate from 29.2% to 12.5%, and need for an additional flap from 14.6.% to 4.2% when compared to conventional treatment. The length of hospital stay decreased as well. Preoperative negative pressure wound therapy alone was associated with moderate decline in the complication rates. In addition, we described the use of split pectoralis major muscle flap reconstruction in 57 patients. To our knowledge, this is the largest published patient series describing this method in the treatment of deep sternal wound infection. Conclusions: Incisional negative pressure wound therapy with PICO™ seems beneficial after flap reconstruction. Split pectoralis major muscle flap is a versatile reconstruction option suitable to be used as a workhorse in the treatment of deep sternal wound infection.


2020 ◽  
Vol 23 (3) ◽  
pp. E281-E284
Author(s):  
Khaled Ebrahim Al-Ebrahim

Deep sternal wound infection (DSWI) after cardiac surgery is a challenging complication that affects the outcome of surgery. The worst type of DSWI is mediastinitis and sternal osteomyelitis, which dramatically increase morbidity, mortality, and cost of care. This case report describes successful treatment of sternal osteomyelitis after open heart surgery with combined negative pressure wound therapy and rectus abdominis flap. This combination of negative pressure wound therapy with rectus abdominis flap in treating sternal osteomyelitis after open cardiac surgery is not well studied.


2013 ◽  
Vol 16 (2) ◽  
pp. 115-119
Author(s):  
Cemalettin Aydın ◽  
Halil Başel ◽  
İbrahim Kara ◽  
Yasin Ay ◽  
Murat Songur ◽  
...  

2020 ◽  
Vol 102-B (7) ◽  
pp. 912-917 ◽  
Author(s):  
Muhammad Tahir ◽  
Ejaz A. Chaudhry ◽  
Faridullah K. Zimri ◽  
Nadeem Ahmed ◽  
Saeed A. Shaikh ◽  
...  

Aims It has been generally accepted that open fractures require early skeletal stabilization and soft-tissue reconstruction. Traditionally, a standard gauze dressing was applied to open wounds. There has been a recent shift in this paradigm towards negative pressure wound therapy (NPWT). The aim of this study was to compare the clinical outcomes in patients with open tibial fractures receiving standard dressing versus NPWT. Methods This multicentre randomized controlled trial was approved by the ethical review board of a public sector tertiary care institute. Wounds were graded using Gustilo-Anderson (GA) classification, and patients with GA-II to III-C were included in the study. To be eligible, the patient had to present within 72 hours of the injury. The primary outcome of the study was patient-reported Disability Rating Index (DRI) at 12 months. Secondary outcomes included quality of life assessment using 12-Item Short-Form Health Survey questionnaire (SF-12), wound infection rates at six weeks and nonunion rates at 12 months. Logistic regression analysis and independent-samples t-test were applied for secondary outcomes. Analyses of primary and secondary outcomes were performed using SPSS v. 22.0.1 and p-values of < 0.05 were considered significant. Results A total of 486 patients were randomized between January 2016 and December 2018. Overall 206 (49.04%) patients underwent NPWT, while 214 (50.95%) patients were allocated to the standard dressing group. There was no statistically significant difference in DRI at 12 months between NPWT and standard dressing groups (mean difference 0.5; 95% confidence interval (CI) -0.08 to 1.1; p = 0.581). Regarding SF-12 scores at 12 months follow-up, there was no significant difference at any point from injury until 12 months (mean difference 1.4; 95% CI 0.7 to 1.9; p = 0.781). The 30-day deep infection rate was slightly higher in the standard gauze dressing group. The non-union odds were also comparable (odds ratio (OR) 0.90, 95% CI 0.56 to 1.45; p = 0.685). Conclusion Our study concludes that NPWT therapy does not confer benefit over standard dressing technique for open fractures. The DRI, SF-12 scores, wound infection, and nonunion rates were analogous in both study groups. We suggest surgeons continue to use cheaper and more readily available standard dressings. Cite this article: Bone Joint J 2020;102-B(7):912–917.


2021 ◽  
Author(s):  
Yi-Fan Wu ◽  
Dong Zhang ◽  
Ai-Xi Yu ◽  
Baiwen Qi ◽  
Chao Jian

Abstract Background: Patients with the inguinal wound infection after arterial surgery remains clinical challenge. Sustaining lymphatic leakage have been shown as a common and potentially serious complication. However, it remains clinical challenge for surgery to deal with this tough problem. Methods: This study describes a hybrid technique of using radical debridement, lateral femoral bypass (LFB) and intra-incisional negative pressure wound therapy (iNPWT) for single-staged treatment of complex inguinal wound infection after arterial surgery (IWI-AS).Results: Between January 2017 and June 2021, 5 IWI-AS cases treated with this new method were identified. Of the patients, 3 were males and 2 were females. The average age was 49.4 years (range, 33 to 77 years). 4 cases suffered emergent operations due to the sudden bleedings. after vascular bypass reconstructions and an average of 2.2 (range:1-3) iNWPT, all cases achieved wound healing at an average duration of 4.6 weeks (range: 3-6weeks). Moreover, all cases showed no bacterial growth and grafts patency as indicated by doppler ultrasound or CT angiography postoperatively. One case did not receive bypass imaging evaluation at postoperative 12 months. Weakness of quadriceps femoris was observed in one case. Conclusion: single-staged therapy of LFB and iNPWT hybridization is a technically handy and effective method for treatment of inguinal wound infection after arterial surgery.


Sign in / Sign up

Export Citation Format

Share Document