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负压封闭引流疗法治疗深部胸骨伤口感染的成本

The cost of vacuum-assisted closure therapy in treatment of deep sternal wound infection.

作者信息

Mokhtari Arash, Sjögren Johan, Nilsson Johan, Gustafsson Ronny, Malmsjö Malin, Ingemansson Richard

机构信息

Department of Cardiothoracic Surgery, Lund University Hospital, Lund, Sweden.

出版信息

Scand Cardiovasc J. 2008 Feb;42(1):85-9. doi: 10.1080/14017430701744469.

Abstract

OBJECTIVES

Surgical sites infections are very expensive and the total costs for coronary artery bypass grafting (CABG) surgery followed by deep sternal wound infection (DSWI) with conventional therapy are estimated to be 2.8 times that for normal, CABG surgery. Promising results have been reported with vacuum-assisted closure (VAC) therapy in patients with DSWI. This study presents the cost of VAC therapy in patients with DSWI after CABG surgery.

DESIGN

Thirty-eight CABG patients with DSWI, between 2001 and 2005, were treated with VAC therapy. The cost of surgery, intensive care, ward care, laboratory tests and other costs were analyzed.

RESULTS

No three-month mortality or recurrent infection was observed. The average cost of CABG procedure and treatment of DSWI was 2.5 times higher than the mean cost of CABG alone. No significant correlations were found between the preoperative EuroSCORE and the cost of DSWI therapy.

CONCLUSIONS

VAC therapy for patients who underwent CABG surgery followed by DSWI seems to be cost effective, and has low mortality rate.

摘要

目的

手术部位感染成本高昂,冠状动脉搭桥术(CABG)后发生深部胸骨伤口感染(DSWI)并采用传统疗法的总成本估计是正常CABG手术的2.8倍。有报道称真空辅助闭合(VAC)疗法对DSWI患者取得了良好效果。本研究展示了CABG术后DSWI患者采用VAC疗法的成本。

设计

2001年至2005年间,38例CABG术后发生DSWI的患者接受了VAC疗法。分析了手术、重症监护、病房护理、实验室检查及其他费用。

结果

未观察到3个月死亡率或复发性感染。CABG手术及DSWI治疗的平均成本比单纯CABG的平均成本高2.5倍。术前欧洲心脏手术风险评估系统(EuroSCORE)与DSWI治疗成本之间未发现显著相关性。

结论

CABG术后发生DSWI的患者采用VAC疗法似乎具有成本效益,且死亡率较低。

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