| Popis: |
Background: The vacuum-assisted system in wound closure (VAC) is a new modality, which is recently used widely as a treatment of severely infected wounds. It is a noninvasive way that improves healing of severely infected wounds that fail to respond to conventional ways of treatment. This type of treatment depends on applying air tight controlled negative pressure suction directly to the infected wounds. The mechanism of action of this treatment depends on allowing the growth of healthy granulation tissues of the infected wounds. Objective: To evaluate the effect of vacuum assisted suction in treatment of deep sternal wound infection after cardiac surgery. Patients and Methods: In Cairo University Hospitals, in the period between January 2018 and January 2019, 17 patients (6 men, 11 women) with a median age of 62.5 years (range 50 to 75 years) underwent open heart surgery, which was complicated by sternal dehiscence and deep sternal wound infection. All those patients were subjected to the VAC system before any surgical intervention. Results: All patients involved in this study had complete wound healing without need of any major surgical intervention (muscle or omental flaps) even without wound debridement. The VAC system was applied for a mean of 21.5 days (range 15 to 28 days), VAC system was removed when the wound became completely clean with healthy granulation tissues. After removal of the VAC system, 9 patients (52.9%) were subjected to closure of the skin and subcutaneous tissues by interrupted stitches while the remaining 8 patients (47.1%) the wound was completely closed in all layers up to the skin. Duration of hospital stay varied from 22 to 45 days (median 33.5 days). There were no mortalities among all the patients who were involved in this study. Conclusion: The VAC system is a noninvasive, safe and very effective as a treatment for deep sternal wound infections following cardiac surgery. |
