Sternal wound infections (SWI) are uncommon but severe complications after cardiac surgery. This condition is associated with high mortality rates. Various strategies have been implemented to reduce the incidence of SWI, such as using rigid longitudinal sternal closures, administering topical antimicrobials, local antibiotics with prolonged release, etc. Despite these, the prevalence of SWI remains significant, with most studies reporting an incidence of 1% to 6%.
According to a recent study published in The American Journal of Surgery, standardized wound care protocol, including the universal application of negative pressure wound therapy ( NPWT )for cardiac surgery patients with median sternotomy, is an independent predictor of decreased sternal infection rates.
SWI is a source of morbidity and mortality following median sternotomy. The impact of incisional NPWT in prevention has yet to be elucidated.
This retrospective study was conducted following the implementation of universal wound care protocol, including the prophylactic use of NPWT. The primary endpoint was sternal infections within 90 days of the index operation.
The study results are:
In the control period, the sternal infection rate was 3 % within 90 days compared to 0.8% in the intervention period.
The odds ratio was 0.25 in the intervention period compared to the control period.
The study aimed to assess if incisional negative pressure wound therapy decreased the occurrence of surgical site infections in patients who underwent cardiac surgery with median sternotomy.
Based on the results of this study, using standardized wound care protocol, including the universal application of iNPWT for patients undergoing cardiac surgery with median sternotomy, is an independent predictor of decreased rates of SWI.
Reference:
Traylor, L., Bhatia, G., Blackhurst, D. W., Wallenborn, G., Ewing, A., Bolton, W. D., & Davis, B. R. (2023). Efficacy of incisional negative pressure therapy in preventing post-sternotomy wound complications. The American Journal of Surgery, 226(6), 762–767. https://doi.org/10.1016/j.amjsurg.2023.07.016