First Experiences with Incisional Negative Pressure Wound Therapy in a High-Risk Poststernotomy Patient Population treated with Pectoralis Major Muscle Flap for Deep Sternal Wound Infection

Stefanie Nickl; Johannes Steindl; Daniel Langthaler; Alina Nierlich-Hold; Igor Pona; Wolfgang Hitzl; Alfred Kocher; Wolfgang Happak; Christine Radtke; Chieh-Han Tzou

doi:10.1055/s-0037-1605379

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2018; 34(01): 001-007
DOI: 10.1055/s-0037-1605379

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

First Experiences with Incisional Negative Pressure Wound Therapy in a High-Risk Poststernotomy Patient Population treated with Pectoralis Major Muscle Flap for Deep Sternal Wound Infection

Stefanie Nickl

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Johannes Steindl

²Department of Cardiac Surgery, Paracelsus Medical Unversity, Salzburg, Austria

,

Daniel Langthaler

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Alina Nierlich-Hold

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Igor Pona

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Wolfgang Hitzl

³Research Office, Biostatistics, Paracelsus Medical University Salzburg, Austria

,

Alfred Kocher

⁴Department of Surgery, Division of Cardiac Surgery, Medical University of Vienna, Vienna, Austria

,

Wolfgang Happak

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Christine Radtke

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

,

Chieh-Han Tzou

¹Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria

› Institutsangaben

Abstract

Background Radical debridement and wound closure with vascularized flaps has become a standard procedure in the treatment of deep sternal wound infections. Negative pressure incision management systems have been proven to diminish wound infections after sternotomy. In this study, the utility of Prevena Incision Management System (KCI Licensing Inc.) was evaluated in obese patients who received unilateral pectoralis major flap for the treatment of deep sternal wound infections.

Methods The outcome and wound-related complication rates of 19 obese patients (mean body mass index, 33.7) treated for deep sternal wound infection with pectoralis major muscle flap in combination with Prevena between 2011 and 2016 were compared with 28 obese patients treated with conventional wound dressing only between 2000 and 2010.

Results In patients additionally treated with Prevena, significantly fewer surgical revisions due to wound-related complications were necessary as compared with patients who received conventional wound dressing (5.3 vs. 32.1%, p = 0.034). A significantly shorter ICU length of stay (median 0 vs. 3.5 days, p < 0.001) and a trend toward shorter length of hospitalization (median 14 vs. 19.5 days after pectoralis major flap) could be observed.

Conclusion The application of Prevena significantly reduced revision surgery rates in obese patients treated with unilateral pectoralis major flap for deep sternal wound infections.

Keywords

deep sternal wound infection - pectoralis major muscle flap - surgical incision management system

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Referenzen

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