Thorac Cardiovasc Surg 2022; 70(01): 065-071
DOI: 10.1055/s-0041-1731767
Original Cardiovascular

Does Incisional Negative Pressure Wound Therapy Prevent Sternal Wound Infections?

1   Department of Plastic Surgery, Kuopio University Hospital, Kuopio, Finland
2   University of Eastern Finland School of Medicine, Kuopio, Pohjois-Savo, Finland
,
Jari Halonen
2   University of Eastern Finland School of Medicine, Kuopio, Pohjois-Savo, Finland
3   Department of Cardiothoracic Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
,
Annastiina Husso
3   Department of Cardiothoracic Surgery, Kuopio University Hospital, Kuopio, Pohjois-Savo, Finland
,
Helli Väänänen
1   Department of Plastic Surgery, Kuopio University Hospital, Kuopio, Finland
,
Leena T. Berg
4   Department of Plastic Surgery, Kainuu Central Hospital, Kajaani, Kainuu, Finland
› Author Affiliations

Abstract

Background Incisional negative pressure wound therapy has been described as an effective method to prevent wound infections after open heart surgery in several publications. However, most studies have examined relatively small patient groups, only a few were randomized, and some have manufacturer-sponsorship. Most of the studies have utilized Prevena; there are only a few reports describing the PICO incisional negative pressure wound therapy system.

Methods We conducted a prospective cohort study involving a propensity score-matched analysis to evaluate the effect of PICO incisional negative pressure wound therapy after coronary artery bypass grafting. A total of 180 high-risk patients with obesity or diabetes were included in the study group. The control group included 772 high-risk patients operated before the initiation of the study protocol.

Results The rates of deep sternal wound infections in the PICO group and in the control group were 3.9 and 3.1%, respectively. The rates of superficial wound infections needing operative treatment were 3.1 and 0.8%, respectively. After propensity score matching with two groups of 174 patients, the incidence of both deep and superficial infections remained slightly elevated in the PICO group. None of the infections were due to technical difficulties or early interruption of the treatment.

Conclusion It seems that incisional negative pressure wound therapy with PICO is not effective in preventing wound infections after coronary artery bypass grafting. The main difference in this study compared with previous reports is the relatively low incidence of infections in our control group.



Publication History

Received: 08 March 2021

Accepted: 29 April 2021

Article published online:
14 September 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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