VAC Therapy Use in the Treatment of Complicated Post-Surgical Wounds in Cardiosurgery. Our Experience

• Main Author: V. Beleiovych
• Format: Article
• Language: English
• Published: Professional Edition Eastern Europe 2019-05-01
• Series: Український журнал серцево-судинної хірургії
• Subjects: vac therapy; infectious wounds; sternotomy; cardiac surgery
• Online Access: http://cvs.org.ua/index.php/ujcvs/article/view/126

Introduction. Wound infection as a complication after cardiosurgery is a dangerous condition which significantly in-creases the length of stay and raises the risk of post-surgical complications; this condition is one of the most threatening and may even cause death. The aim. To improve the treatment outcomes in cardiac surgery department patients with infected wounds through the vacuum-assisted closure (VAC) therapy. Materials and methods. Analysis of the results of VAC therapy in 8 patients with post-surgical infected wounds after sternal operations was carried out. In all the patients VAC therapy was as a first-line therapeutic option, and treatment al-gorithm was the same in each case of wound infection. Vacuum system was changed every 3–6 days as appropriate. Negative culture test, absence of exudates or granulation in the wound were indications for VAC therapy cessation. Results and discussion. All patients were treated successfully. In our study we had 6 patients with 3-5 days of vacuum therapy, 70 ± 42 ml exudate was evacuated from wounds. Two patients underwent vacuum suction treatment for 7 ± 5.5 days. VAC system was replaced every 4–6 days. In general, 200 ± 105 (80–40) ml of exudates was evacuated. For all the period of treatment using the VAC system, the total amount of exudates was 170 ± 55 ml. No correlation for any type of bacterial flora and type of wound was observed. 100 % of patients have had indications for secondary suture placement, and this procedure was carried out. Average length of stay in VAC-treated patients was 15 ± 6.4 days, which is twice less than that in patients after using stan-dard methods of treatment. During this study, we have received convincing evidence that VAC therapy really contributes to proliferation and neo-angiogenesis, improves blood supply to the affected tissues, which, in turn, provides better circulation of antibacterial agents and immune cells. Successful treatment of all participants in this study proves the above mentioned fact. Conclusion. Vacuum system is a safe, cost-effective and useful method of treating infected wounds after cardiac surgery. It promotes rapid healing of wounds with a short length of stay, leads to early rehabilitation and improves patient satisfaction with minimal discomfort.