Abstract
Background Incisional negative pressure wound therapy has been described as an effective method
to prevent wound infections after open heart surgery in several publications. However,
most studies have examined relatively small patient groups, only a few were randomized,
and some have manufacturer-sponsorship. Most of the studies have utilized Prevena;
there are only a few reports describing the PICO incisional negative pressure wound
therapy system.
Methods We conducted a prospective cohort study involving a propensity score-matched analysis
to evaluate the effect of PICO incisional negative pressure wound therapy after coronary
artery bypass grafting. A total of 180 high-risk patients with obesity or diabetes
were included in the study group. The control group included 772 high-risk patients
operated before the initiation of the study protocol.
Results The rates of deep sternal wound infections in the PICO group and in the control group
were 3.9 and 3.1%, respectively. The rates of superficial wound infections needing
operative treatment were 3.1 and 0.8%, respectively. After propensity score matching
with two groups of 174 patients, the incidence of both deep and superficial infections
remained slightly elevated in the PICO group. None of the infections were due to technical
difficulties or early interruption of the treatment.
Conclusion It seems that incisional negative pressure wound therapy with PICO is not effective
in preventing wound infections after coronary artery bypass grafting. The main difference
in this study compared with previous reports is the relatively low incidence of infections
in our control group.
Keywords
CABG - sternum - surgery - complications - wound healing - wound infection
