The impact of Negative Pressure Wound Dressing on median sternotomy infection for high risk cardiac cases: Single Centre Study
Rona L. Suelo- Calanao, Richard Thomson, Maxine Read, Mubarak Chaudhry, Mahmoud Loubani.
Castle Hill Hospital, Hull, United Kingdom.
OBJECTIVE: Sternal Wound Infection (SWI) following cardiac surgery is a recognised major complication. It has a significant impact on patient recovery, treatment cost and can affect mortality rates.
There is no existing universal guideline on the management of sternal wounds and more recently the focus has become prevention rather than treatment. Recent studies reported the use of negative pressure dressings on sterile surgical wounds, particularly for patients at risk of poor wound healing.
This study aims to assess the effect of using Negative Pressure Wound Dressing (NPWD), an interactive sealed dressing, on the prevalence of SWI on the identified high risk patients.
METHODS:A retrospective study to demonstrate the clinical benefit of NPWD versus standard sterile dressing on prevention of SWI.
Patients were selected 3 years from the introduction of NPWD, and then compared to patients 3 years after NPWD.
All patients from each cohort were also grouped separately using the risk factors that our centre has identified from a previous study (Arityaratnam, et al., 2010). Patients with 2 or more risk factors were given NPWD and the rest were given sterile standard dressings.
All variables are compared using mean +/- standard deviation.
The Fishers exact test, two- tailed was used to calculate the p-value for all categorical data.
An unpaired t-test, two- tailed was used to calculate the p-value for all continuous data.
RESULTS: The incidence of sternal wound infection decrease to 4.4% with the introduction of NPWD compared to 8.7% using standard sterile dressing demonstrating a 50% reduction of SWI for all cases.
For patients with 2 or more risk factors there is a reduction of 55% of SWI cases with the use of NPWD and more importantly there are no cases requiring debridement compared to sterile standard dressing.
CONCLUSIONS: Negative Wound Pressure Dressing reduces median sternotomy infection in identified high risk cases. This may result in shorter hospital stay, decrease mortality rate and financial cost.
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