Vacuum-assisted closure (VAC®) systems and microbiological isolation of infected wounds

Cozza, Valerio; Pepe, Gilda; Cintoni, Marco; Maio, Flavio De; Tropeano, Giuseppe; Magalini, Sabina; Sganga, Gabriele; Delogu, Giovanni; Gui, Daniele

doi:10.1186/s13017-018-0216-z

Cited by 12 publications

(6 citation statements)

References 17 publications

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“…Some studies showed higher incidence in male patients, but some studies confirm higher incidence in female patients. In our sample of patients, 60% were males and 40% were females ( 8 , 9 ).…”

Section: Discussionmentioning

confidence: 74%

Deep Sternal Wound Infection After Open-heart Cardiac Surgery and Vacuum-Assisted Closure Therapy: a Single-center Study

Banjanovic¹,

Karabdic²,

Straus³

et al. 2022

Med Arch

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Background: Despite many advances in the prevention, of sternal wound infection, especially deep ones, cardiac surgery with median sternotomy, still presents a significant postoperative complication. Numerous operative and non-operative procedures should be used in treatment, there is a prolonged hospital stay and increased hospital costs treating this postoperative complication. Objective: The present study was conducted aiming to determine the incidences, and risk factors, identify microbiology findings, and antibiotic therapy among patients with DSWI who underwent cardiac surgery with median sternotomy at our Clinic and VAC treatment. Methods: This retrospective observational study was conducted in Clinic for Cardiovascular Surgery at University Clinical Center Sarajevo from November 2015 to November 2020. The data were obtained from 15 patients with deep sternal wound infection (DSWI) following open-heart surgery. The inclusion criteria were DSWI after cardiac operation via median sternotomy, and complete results of microbiological findings obtained by sternal swab. The exclusion criteria were patients with incomplete clinical data. Results: We found that 9 (60%) patients were males and 6 (40%) were females. Coronary artery bypass grafting (CABG) operation had 11 (73,3%) patients, CABG with aortic valve replacement 2 (13,3%), valve replacement surgery operations (13,3%). The average age was 66 years. All patients were elective surgery patients. STS score in the Non-VAC group was 22.6, in the VAC group 16.6, and the average was 14.9. The number of patients with DSWI represents 1% of all sternotomy patients in the observed period. Two risk factors for DSWI had 37% of patients, 25% of them were diabetic, and 3 (9%) were overweight. Enterococcus faecalis was isolated predominantly in 6 (27%) patients, followed by Klebsiella pneumonia 3 (13%), Proteus mirabilis 2 (9%), and Serratia Maecenas 2 (9%). The mortality rate was 33.3% (5 of 15). Conclusion: The results of our study present our experience with DSWI treatment after open-heart surgery. What comes from our experience so far, is that is very important to determine patients who are at risk of developing DSWI after cardiac surgeries to lower its incidence.

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Section: Discussionmentioning

confidence: 74%

Deep Sternal Wound Infection After Open-heart Cardiac Surgery and Vacuum-Assisted Closure Therapy: a Single-center Study

Banjanovic¹,

Karabdic²,

Straus³

et al. 2022

Med Arch

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“…Contracción de la herida (macro deformación). Los efectos secundarios incluyen un aumento de la angiogénesis, formación de tejido de granulación y disminución del recuento bacteriano (14)(15). Este principio ha sido trasladado al manejo de las fugas anastomóticas del tracto digestivo superior e inferior que sean accesibles por vía endoscópica obteniendo cierres exitosos (16).…”

Section: Discussionunclassified

Terapia endoscópica de presión negativa para cierre de fístula esófago-yeyunal. Reporte de caso

Velásquez-Cuasquen¹,

Romo-Romero²,

Meza-Rodríguez³

et al. 2021

Rev. Fac. Med.

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Introducción. Las fístulas esófago-yeyunales postquirúrgicas pueden llegar a ser mortales. En la actualidad, existen varias alternativas de tratamiento. En los últimos años, la terapia endoscópica de presión negativa se ha convertido un método innovador para el manejo de estas fístulas que ofrece grandes ventajas. Presentación del caso. Hombre de 72 años diagnosticado con adenocarcinoma gástrico de cuerpo y fondo a quien se le realizó gastrectomía total, linfadenectomía D2 y anastomosis en Y de Roux con intención curativa en un hospital de cuarto nivel en Popayán, Colombia. Sin embargo, en el posoperatorio, presentó síndrome de respuesta inflamatoria sistémica (SRIS) y abdomen agudo producto de fístula esófago-yeyunal. Se realizó manejo inicial con laparotomía, dos lavados de cavidad peritoneal y drenaje abdominal. Posteriormente, el paciente desarrolló abdomen congelado, por lo que no fue posible acceder la anastomosis esófago-yeyunal. Se intentó cierre de fístula mediante la inserción de prótesis metálica autoexpandible, pero el procedimiento no fue exitoso. Se inició terapia de rescate mediante sistema de cierre asistido por vacío (VAC) por vía endoscópica. Luego de 5 recambios del sistema VAC, se logró el drenaje completo de la peritonitis, el cierre completo de la cavidad peritoneal y el cierre de la fuga esófago-yeyunal, con una pequeña formación diverticular residual. La condición del paciente mejoró progresivamente, con reinicio de la vía oral a los 20 días. Además, no se reportaron nuevas complicaciones abdominales en el periodo de seguimiento (17 meses). Conclusión. La terapia endoscópica de VAC es una nueva alternativa segura y efectiva para el tratamiento de fístulas post quirúrgicas complejas producto de anastomosis esófago-yeyunales.

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“…Yadav et al have found better results with NPWT in managing chronically infected wounds compared with conventional technique [12]. Cozza et al conducted a prospective experimental study including more than 10 patients and found that NPWT is not a risk factor for health care personnel associated with the management of infections [13]. Arundel et al in their randomized control study comparing NPWT with routine wound management found that healing of surgical wounds by secondary intention is very difficult.…”

Section: Discussionmentioning

confidence: 99%

Negative Pressure Wound Therapy Assisted Closure: An Effective Mode of Management for Infected and Contaminated Wound With Non-Union Fracture Femur

Patro

Khuntia

Sahu

et al. 2020

Cureus

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High-energy open fractures are often associated with significant soft tissue damage and can have contamination. Infection of a fracture can be the most detrimental factor for fracture union. Control of infection and soft tissue coverage over exposed bone plays a vital role in its overall outcome. Negative pressure wound therapy (NPWT) assisted closure has depicted encouraging results for helping control of infection and wound closure. NPWT assisted closure promotes reduction of bacterial load in the wound, facilitates removal of secretion from the wound, promotes the formation of granulation tissue, and decreases wound size. We present a case of open fracture femur with severe infection and exposed bone. Along with infection and comminution of fracture, there was collection of necrotic tissue at the fracture site. Infection settled with debridement of wound and application of NPWT. With the application of NPWT, there was formation of granulation tissue and a decrease in wound size. The wound healed completely following application of secondary sutures. Any form of plastic procedures, such as muscle pedicle graft and split-thickness skin grafting, was not required for wound closure. NPWT-assisted closure is a promising mode of wound management in grossly infected wounds and obviates the need for further plastic procedures. The effect can be extrapolated to all open wounds with infection but must follow a thorough debridement and lavage.

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Vacuum-assisted closure (VAC®) systems and microbiological isolation of infected wounds

Cited by 12 publications

References 17 publications

Deep Sternal Wound Infection After Open-heart Cardiac Surgery and Vacuum-Assisted Closure Therapy: a Single-center Study

Deep Sternal Wound Infection After Open-heart Cardiac Surgery and Vacuum-Assisted Closure Therapy: a Single-center Study

Terapia endoscópica de presión negativa para cierre de fístula esófago-yeyunal. Reporte de caso

Negative Pressure Wound Therapy Assisted Closure: An Effective Mode of Management for Infected and Contaminated Wound With Non-Union Fracture Femur

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