Abstract:Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid-and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at highrisk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylac… Show more
“…The mechanism by which NPWT is thought to promote wound healing is through increasing local perfusion, eliminating tissue oedema, drawing wound edges together, removing exudates and proinflammatory cytokines, inhibiting bacterial growth and promoting cell hyperplasia. NPWT systems have been widely adopted for a broad range of indications in acute and chronic wounds .…”
Exact data regarding the clinical role of negative pressure wound therapy (NPWT) for wound care in a specific country are not available. Thus, we analysed the use of NPWT in hospitalised patients in Germany. Detailed lists of all hospitalised cases treated with NPWT in Germany for each of the years from 2005 to 2014 were obtained from the Federal Statistical Office, as well as lists of the 15 most frequent principal and additional diagnoses documented with NPWT in 2014. Within the 10-year time period of the study, the number of cases treated with NPWT increased by 349%, from 37 053 in 2005 to 129 269 in 2014. The rate of all hospitalised cases treated with NPWT increased form 0·22% to 0·66% in Germany. In 2014, wounds affecting skin and subcutaneous tissue (5-916.a0) are the most frequent documented indication for NPWT followed by deep wounds involving bones and joints at the limbs (5-916.a1). Open abdomens (5-916.a3) count for higher numbers than deep wounds of the thorax, mediastinum and sternum (5-916.a2). Fifty percent of all cases hospitalised for stage IV pressure ulcers at sacrum or ischium and around one third (32.2%) of cases with pyothorax received NPWT. Every fourth to fifth case hospitalised for disruption of surgical wounds or infections following a procedure (24·1%), as well as for infections and inflammations because of internal joint prosthesis or because of an internal fixation device was treated with NPWT (22·9%). In cases with diabetic foot syndrome, it is still every tenth case (10·1%). This analysis shows a substantial increase in the use of NPWT in the last decade for hospitalised patients. NPWT has a fixed role in the treatment of stage IV pressure ulcers at sacrum or ischium, pyothorax, infection and inflammation because of internal joint prosthesis or an internal fixation device and diabetic foot syndrome.
“…The mechanism by which NPWT is thought to promote wound healing is through increasing local perfusion, eliminating tissue oedema, drawing wound edges together, removing exudates and proinflammatory cytokines, inhibiting bacterial growth and promoting cell hyperplasia. NPWT systems have been widely adopted for a broad range of indications in acute and chronic wounds .…”
Exact data regarding the clinical role of negative pressure wound therapy (NPWT) for wound care in a specific country are not available. Thus, we analysed the use of NPWT in hospitalised patients in Germany. Detailed lists of all hospitalised cases treated with NPWT in Germany for each of the years from 2005 to 2014 were obtained from the Federal Statistical Office, as well as lists of the 15 most frequent principal and additional diagnoses documented with NPWT in 2014. Within the 10-year time period of the study, the number of cases treated with NPWT increased by 349%, from 37 053 in 2005 to 129 269 in 2014. The rate of all hospitalised cases treated with NPWT increased form 0·22% to 0·66% in Germany. In 2014, wounds affecting skin and subcutaneous tissue (5-916.a0) are the most frequent documented indication for NPWT followed by deep wounds involving bones and joints at the limbs (5-916.a1). Open abdomens (5-916.a3) count for higher numbers than deep wounds of the thorax, mediastinum and sternum (5-916.a2). Fifty percent of all cases hospitalised for stage IV pressure ulcers at sacrum or ischium and around one third (32.2%) of cases with pyothorax received NPWT. Every fourth to fifth case hospitalised for disruption of surgical wounds or infections following a procedure (24·1%), as well as for infections and inflammations because of internal joint prosthesis or because of an internal fixation device was treated with NPWT (22·9%). In cases with diabetic foot syndrome, it is still every tenth case (10·1%). This analysis shows a substantial increase in the use of NPWT in the last decade for hospitalised patients. NPWT has a fixed role in the treatment of stage IV pressure ulcers at sacrum or ischium, pyothorax, infection and inflammation because of internal joint prosthesis or an internal fixation device and diabetic foot syndrome.
“…1,2,4,5 Microbial cultures of SSIs in our study predominantly grew Staphylococcus aureus, 60% of which were methicillin-resistant. Despite changes in antibiotic prophylaxis duration and postoperative skin treatment, our data demonstrate a stable incidence and composition of wound infections during the study period.…”
Section: Discussionmentioning
confidence: 71%
“…6,7 Mitigation of individual patients factors such as tight glycemic control, use of particular skin preparation agents, and wound dressings have met variable success in reducing SSIs. 5,8,9 Recent studies also indicate that daily chlorhexidine baths significantly reduce hospital-acquired infections; however, neither the Center for Disease Control and Prevention (CDC) nor the World Health Organization (WHO) have reported an optimum unified recommendation of skin antiseptic practices or antibiotic prophylaxis strategies. 5,8,9 Recent studies also indicate that daily chlorhexidine baths significantly reduce hospital-acquired infections; however, neither the Center for Disease Control and Prevention (CDC) nor the World Health Organization (WHO) have reported an optimum unified recommendation of skin antiseptic practices or antibiotic prophylaxis strategies.…”
Despite changes in antibiotic prophylaxis duration and postoperative skin treatment, our data demonstrate a stable incidence and composition of surgical wound infections during the study period. doi: 10.1111/jocs.12756 (J Card Surg 2016;31:367-372).
“…(Ann Thorac Surg 2016;-:---) Ó 2016 by The Society of Thoracic Surgeons S urgical site infections and hypertrophic scars are the major postsurgical wound complications, and these sometimes can occur after cardiovascular operations [1][2][3]. The use of several skin closure devices, such as cyanoacrylate glue and surgical staples, has been reported [4][5][6], and these devices have been demonstrated to have good potential in reducing skin closure time, improving cosmetic appearance, and decreasing infection rate.…”
In congenital heart operations through a median sternotomy, the Zip surgical skin closure device was an excellent choice for improving the cosmetic appearance and reducing the wound closure time. In addition, it proved to be a device that could be used safely.
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