Assessment of the Effect of Incisional Negative Pressure Wound Therapy for Prevention of Median Sternotomy Wound Infection

Abstract

Background: Sternal wound infection is a catastrophic complication after open heart surgery, so many studies have evaluated the effect  of negative pressure wound therapy (NPWT) to prevent it.

Objective: This study aimed to evaluate the impact of incisional negative  pressure wound therapy on the wound healing process after midline sternotomy in open heart surgery.

Patients and methods: 100  patients who underwent open heart surgery with midline sternotomy were included. They were divided equally into two groups: Group A  included 50 patients who had negative pressure wound therapy and group B that contained 50 patients who had conventional wound  dressing.

Results: Patients who underwent negative pressure wound therapy had significantly lower incidences of TLC rising (P=0.043),  and CRP rising (P=0.017), significantly lower incidences of overall post-operative wound infection (P=0.025), significantly lower post- operative progression to deep wound infection (P=0.024), significantly lower need for post-operative deep wound intervention (P=0.012),  significantly shorter ICU stay (P=0.001), as well as shorter hospital stay (P=0.018) when compared to patients who had conventional  wound dressing. Also, no mortality was detected among our studied patients.

Conclusion: Negative pressure wound therapy was  superior to conventional wound dressing as it was associated with significantly lower incidences of TLC and CRP rising, significantly lower incidences of overall post-operative wound infection and post-operative deep wound infection, significantly lower need for post-operative  deep wound intervention, as well as significantly shorter ICU stay (due to readmission) and hospital stay, when compared to  conventional wound dressing.