부산대학교 도서관

Aim: We sought to evaluate a five year single centre experience for the application of topical negative pressure therapy (TNP) as the first-line therapy in the treatment of deep sternal wound infection (DSWI) following cardiac surgery. Methods: Prospective analysis of 50 consecutive patients (27 men, 23 women, mean age 67.8±9.2 years) who underwent first-line application of topical negative pressure for the treatment of deep sternal wound infection within a five year period (from September 2004 to September 2009). Clinical and wound care outcomes were evaluated, therapeutic failure rates, in-hospital and as well as the one year mortality of unified application protocol. Results: During follow-up 4% of 30-day mortality, 8% of in-hospital mortality, and 14% of one year mortality (10% DSWI-related complication adjusted) were observed. The mean length of overall therapy reached 12.6±8.0 days including the mean of 5.4±2.5 revision/dressing changes within 38.1±14.6 days of the mean in-hospital stay. he sternal bone was stabilized in 94% of cases; various flaps were employed in covering of the residualsoft tissue defect in 70% of patients. Treatment failed in 6% of all cases, 4% due to DSWI recurrence, and 2% due to necrosis of the advanced muscle flap. The risk of wire-related fistula was 14% during whole follow-up period. Conclusion: TNP therapy is a reliable method for the treatment of DSWI following cardiac surgery. The primary application of TNP demonstrated a low risk of failure and a significant decrease in short- and mid-term mortality was observed.