Open AccessEffect of surgical incision management on wound infections in a poststernotomy patient population
Author(s) -
Grauhan Onnen,
Navasardyan Artashes,
Tutkun Baris,
Hennig Felix,
Müller Peter,
Hummel Manfred,
Hetzer Roland
Publication year - 2014
Publication title -
international wound journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.867
H-Index - 63
eISSN - 1742-481X
pISSN - 1742-4801
DOI - 10.1111/iwj.12294
Subject(s) - medicine , surgery , incidence (geometry) , wound healing , surgical wound , odds ratio , wound infection , negative pressure wound therapy , clinical endpoint , anesthesia , randomized controlled trial , physics , alternative medicine , pathology , optics
Skin breakdown and infiltration of skin flora are key causative elements in poststernotomy wound infections. We hypothesised that surgical incision management ( SIM ) using negative pressure wound therapy over closed surgical incisions for 6–7 days would reduce wound infections in a comprehensive poststernotomy patient population. ‘All comers’ undergoing median sternotomy at our institution were analysed prospectively from 1 September to 15 October 2013 (study group, n = 237) and retrospectively from January 2008 to December 2009 (historical control group, n = 3508). The study group had SIM (Prevena™ Therapy) placed immediately after skin suturing and applied at −125 mmHg for 6–7 days, whereas control group received conventional sterile wound tape dressings. Primary endpoint was wound infection within 30 days. Study group had a significantly lower infection rate than control group: 1·3% (3 patients) versus 3·4% (119 patients), respectively ( P < 0·05; odds ratio 2·74). In the study group, when the foam dressing was removed after 6–7 days, the incision was primarily closed in 234 of 237 patients (98·7%). SIM over clean, closed incisions for the first 6‐7 postoperative days significantly reduced the incidence of wound infection after median sternotomy. Based on these data SIM may be cost‐effective in patients undergoing cardiac surgery.