The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections—A retrospective cohort study

Abstract

Abstract Background and Aims Negative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi‐d) in the treatment of DSWI. Methods We retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi‐d. The NPWTi‐d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite <0.08% with a 3‐min dwell time. Results The NPWTi‐d group showed a shorter length of stay (29.39 ± 12.09 vs. 39.54 ± 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 ± 4.27 vs. 11.86 ± 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 ± 1.14 vs. 2.68 ± 56; p < 0.001). The in‐hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). Conclusion NPWTi‐d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi‐d in the control of infection and biofilm as well as in wound healing.

Keywords

• cardiac surgery
• instillation
• negative pressure wound therapy
• surgical wound infection
• wound healing