Modified method of vacuum therapy in the treatment of infected poststernotomy wounds

Abstract

Sternal wound infections are a terrible complication that require long and complex treatment.The aim of the study was to evaluate the results of using the modified method of vacuum therapy to treat purulentseptic complications of post-sternotomy wounds in clinical practice.Materials and methods. According to the applied method of vacuum therapy, all patients with infectious complications of post-sternotomy wounds were divided into two groups (n = 25, average age 56.6 years). The classical vacuum therapy was used in the first group consisting of 12 patients. In the second group, 13 patients were treated with the help of the modified method of vacuum therapy.Results. In the first group, 1 patient (8.3%) experienced osteomyelitis of the sternum, following a partial resection of bone plates; 1 patient (8.3%) developed sternal fistulas, which required long-term treatment; 1 patient (8.3%) had bleeding due to the injury of the left brachiocephalic venous trunk because of the direct contact of the polyurethane pad with the blood vessel wall. The bleeding was eliminated by fixing the damaged area of the vascular wall with U-shaped sutures using polytetrafluoroethylene pads. In the second group, no complications of this nature were observed. The modified method of vacuum therapy allows for the effective evacuation of the hemorrhagic discharge of the wound surface, the reduction of the degree of pathogen contamination in the adjacent tissues, and the elimination of bleeding risk .Conclusion. The modified method of vacuum therapy in combination with effective algorithms for treating purulent-septic complications of post-sternotomy wounds allows physicians to avoid fatal complications and achieve good clinical results.

Keywords

• срединная стернотомия
• стернальная инфекция
• послеоперационный медиастинит
• вакуум-терапия
• реостеосинтез грудины