Philip B, McCluskey P, Hinchion J
Registrar, Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Republic of Ireland.
Advance Nurse Practitioner in Wound Care & Tissue Viability, Department of Cardiothoracic Surgery, Cork University Hospital, Cork, Republic of Ireland.
J Wound Care. 2017 Aug 2;26(8):491-495. doi: 10.12968/jowc.2017.26.8.491.
Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre.
A retrospective record review identified 10 patients (4 females, 6 males) where ciNPT was used following sternotomy for cardiac surgery or other mediastinal surgery between January 2012 and March 2013.
The patients had an average age of 71.5±14.18 years (range: 44-89 years). Patient comorbidities included obesity, hypertension, active tobacco use, chronic obstructive pulmonary disease, and diabetes mellitus. Patients underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR), AVR and CABG, or removal of a thymic mass or mediastinal cyst. ciNPT was left in place for an average of 6±0.82 days. All incisions healed without complications.
ciNPT use should be considered for patients at risk for postoperative SSI development or other wound complications.
术后伤口愈合延迟、手术部位感染（SSIs）及其他伤口并发症与发病率增加和医疗费用上升相关。在心胸外科手术中，伤口并发症可能会带来危及生命的后果。近年来，负压伤口治疗（NPWT）已应用于闭合的手术切口，以帮助减轻张力并防止外部污染。我们报告了在爱尔兰一家三级转诊中心，对清洁的闭合胸骨切开术切口使用闭合切口负压治疗（ciNPT）的初步经验。
通过回顾性病历审查，确定了2012年1月至2013年3月期间，10例在心脏手术或其他纵隔手术胸骨切开术后使用ciNPT的患者（4例女性，6例男性）。
患者的平均年龄为71.5±14.18岁（范围：44 - 89岁）。患者的合并症包括肥胖、高血压、当前仍吸烟、慢性阻塞性肺疾病和糖尿病。患者接受了冠状动脉旁路移植术（CABG）、主动脉瓣置换术（AVR）、AVR和CABG，或胸腺肿块或纵隔囊肿切除术。ciNPT平均留置6±0.82天。所有切口均愈合且无并发症。
对于有发生术后SSI或其他伤口并发症风险的患者，应考虑使用ciNPT。
