Department of Plastic Surgery, Kuopio University Hospital, Kuopio, Finland.
Faculty of Medicine, University of Eastern Finland, Kuopio, Finland.
Scand Cardiovasc J. 2021 Dec;55(6):327-332. doi: 10.1080/14017431.2021.1955963. Epub 2021 Jul 24.
. Negative pressure wound therapy (NPWT) has widely become the first-line option in the treatment of deep sternal wound infections. After several positive reports in comparison with conventional treatment, very recent studies comparing NPWT with early reconstruction have favored the latter. Our aim was to evaluate the effectiveness and safety of NPWT in comparison with early flap reconstruction. . We concluded a retrospective analysis of 125 patients with deep sternal wound infection treated in a single institution between the years 2006 and 2018. NPWT became the first-line treatment in our hospital in 2011. The study group consisted of 55 patients treated primarily with NPWT with or without subsequent flap reconstruction. The control group consisted of 60 patients treated with flap reconstruction without prior NPWT. Ten patients with an immediate re-fixation and direct wound closure were excluded. . There were no significant differences between the two groups concerning the type or urgency of the original open-heart surgery, age, gender, or co-morbidities. In the NPWT group there was significantly higher mortality ( = .002), longer stay in the intensive care unit ( = .028), and in the university hospital ( < .001) as well as higher number of operations ( < .001). However, there were somewhat more surgical complications in the control group as well as a higher number of distant flap reconstructions. Overall, five patients suffered from NPWT associated bleeding. . Our results raise concerns about the wide use of NPWT as a first-line treatment of deep sternal wound infections. Further evaluative studies are warranted to confirm the results.
. 负压伤口治疗（NPWT）已广泛成为治疗深部胸骨伤口感染的一线选择。与传统治疗方法相比，NPWT 有几项积极的报告后，最近的研究比较了 NPWT 与早期重建，后者更有利。我们的目的是评估 NPWT 与早期皮瓣重建的有效性和安全性。. 我们回顾性分析了 2006 年至 2018 年在一家机构治疗的 125 例深部胸骨伤口感染患者。NPWT 于 2011 年成为我们医院的一线治疗方法。研究组由 55 例接受 NPWT 治疗的患者组成，其中一些患者接受了 NPWT 联合或不联合随后的皮瓣重建。对照组由 60 例接受皮瓣重建而未接受 NPWT 的患者组成。排除了 10 例立即重新固定和直接缝合的患者。. 两组患者在原始开胸手术的类型或紧急程度、年龄、性别或合并症方面无显著差异。在 NPWT 组，死亡率显著更高（ = .002），重症监护病房（ = .028）和大学医院（ < .001）的住院时间更长，手术次数也更多（ < .001）。然而，对照组的手术并发症略多，远处皮瓣重建的数量也更多。总的来说，有 5 例患者出现 NPWT 相关出血。. 我们的结果对 NPWT 作为深部胸骨伤口感染的一线治疗方法的广泛应用提出了担忧。需要进一步评估性研究来证实这些结果。
