Vacuum-assisted suction drainage versus conventional treatment in the management of poststernotomy osteomyelitis

Abstract

We conclude from our experience in the treatment of 42 patients with poststernotomy osteomyelitis that VASD shortened wound healing and hospital stay and thus proved to be an excellent alternative to conventional open management of these wounds.

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…913,914,973 Although several studies have suggested that vacuumassisted closure therapy can be a successful alternative to conventional standard therapy, [913][914][915][916][917][918][919][920][921]973 the data are from single-center retrospective studies of patients with heterogeneous disease processes. As a result, it seems reasonable to suggest that both conventional and vacuum-assisted closure therapy can be used in the treatment of mediastinitis.…”

Negative Pressure Wound Therapy

“…Wound closure (secondary healing or surgical closure) was described as the incidence of complete wound closure in 2 studies 20,22 and as the time to wound closure (complete or incomplete) in 7 studies 23,[26][27][28]31,36,37 (Table 3). Only 2 of the 5 RCTs 20,26 and 2 of the 4 non-RCTs 28,37 reported a significant advantage in favor of NPWT.…”

“…Of the remaining studies, 7 (reported in 8 articles) were RCTs [20][21][22][23][24][25][26][27] and 10 were non-RCTs. [28][29][30][31][32][33][34][35][36][37] According to information from study registries, authors of publications, and the manufacturer (KCI), a further 19 trials were currently ongoing (n = 7), completed but not published (n = 3), or prematurely terminated (n=5); the status of 4 trials was unknown 38 ( Table 1). Reasons for premature termination of trials included slow enrollment, high attrition rates, changes in clinical practice, and design flaws (KCI, written communication, August 19,2005); none of the results of these 5 trials have been published to date.…”

Vacuum-Assisted Closure in the Treatment of Sternal Wound Infection After Cardiac Surgery

“…Growing experience with VAC treatment in the fi eld of cardiac surgery is showing its over the conventional treatment of sternal infections including either one-step surgical debridement, sternal rewiring and closed mediastinal drainage or repeated debridement, open packing and subsequent sternal reconstruction 8-11, 16, 17 . In the VAC group, freedom from mediastinal microbiological cultures was achieved earlier, C-reactive protein level declined more rapidly, in-hospital stay was shorter, sternal closure was achieved earlier and long-term survival tended to be higher [17][18][19][20] . VAC therapy markedly reduced required surgical intervention and reoperations for persistent infections, even in the group of high-risk patients 19 .…”