Can post-sternotomy mediastinitis be prevented by a closed incision management system?

• Main Authors: Dohmen, Pascal M., Markou, Thanasie, Ingemansson, Richard, Rotering, Heinrich, Hartman, Jean M., van Valen, René, Brunott, Maaike, Kramer, Axel, Segers, Patrique
• Format: Article
• Language: deu
• Published: German Medical Science GMS Publishing House 2014-09-01
• Series: GMS Hygiene and Infection Control
• Subjects: incisional negative pressure therapy; cardiothoracic surgery; surgical wounds; surgical site infection; closed incision management; negative pressure wound therapy (NPWT)
• Online Access: http://www.egms.de/static/en/journals/dgkh/2014-9/dgkh000239.shtml

[english] Post-sternotomy mediastinitis is a serious complication after cardiothoracic surgery and contribute significantly to post-operative morbidity, mortality, and healthcare costs. Negative pressure wound therapy is today’s golden standard for post-sternotomy mediastinitis treatment. A systematic literature search was conducted at PubMed until October 2012 to analyse whether vacuum-assisted closure technique prevents mediastinitis after clean surgical incisions closure. Today’s studies showed reduction of post-sternotomy mediastinitis including a beneficial socio-economic impact. Current studies, however included only high-risk patients, hence furthermore, larger randomised controlled trials are warranted to clarify the benefit for using surgical incision vacuum management systems in the general patient population undergoing sternotomy and clarify risk factor interaction.