De Feo Marisa, Vicchio Mariano, Nappi Gianantonio, Cotrufo Maurizio
Department of Cardiothoracic Sciences, Second University of Naples, V Monaldi Hospital, Italy.
Asian Cardiovasc Thorac Ann. 2010 Aug;18(4):360-3. doi: 10.1177/0218492310375854.
Between January 2002 and January 2009, 39 patients with post-cardiotomy staphylococcal deep sternal wound infection were treated primarily by a vacuum-assisted closure method (group A). Results were compared with those of 30 patients with staphylococcal deep sternal wound infection who received closed mediastinal irrigation with antibiotics (group B). The prevalence of methicillin-resistance was similarly high in both groups (64.1% in A, 56.7% in B). One group B patient died during treatment. The median healing time was significantly shorter at 13 days in group A (mean, 13.5 +/- 3.2 days) compared to 18 days (mean, 21.2 +/- 16.4 days) in group B. Deep sternal wound infection did not recur after vacuum treatment, while 7 (24%) patients in group B suffered a recurrence. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 +/- 11.3 days vs. median, 45 days; mean, 49.2 +/- 19.3 days). The significantly shorter healing time with vacuum-assisted closure was confirmed in both methicillin-sensitive (12 vs. 17 days) and methicillin-resistant infections (14 vs. 21 days). Hospital stay remained significantly shorter in group A (35 vs. 46 days) when only methicillin-resistant deep sternal wound infection was considered.
2002年1月至2009年1月期间，39例心脏术后金黄色葡萄球菌性深部胸骨伤口感染患者主要采用负压封闭引流术进行治疗（A组）。将结果与30例接受抗生素封闭纵隔冲洗的金黄色葡萄球菌性深部胸骨伤口感染患者（B组）进行比较。两组耐甲氧西林的发生率同样高（A组为64.1%，B组为56.7%）。B组有1例患者在治疗期间死亡。A组的中位愈合时间显著缩短，为13天（平均，13.5±3.2天），而B组为18天（平均，21.2±16.4天）。负压治疗后深部胸骨伤口感染未复发，而B组有7例（24%）患者复发。A组的住院时间显著缩短（中位，30.5天；平均，32.2±11.3天 vs. 中位，45天；平均，49.2±19.3天）。在甲氧西林敏感感染（12天 vs. 17天）和耐甲氧西林感染（14天 vs. 21天）中，负压封闭引流术的愈合时间均显著缩短。仅考虑耐甲氧西林深部胸骨伤口感染时，A组的住院时间仍显著缩短（35天 vs. 46天）。
