Department of Cardiac Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland.
Department of Anesthesiology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland.
J Wound Care. 2023 Aug 1;32(Sup8a):S24-S30. doi: 10.12968/jowc.2023.32.Sup8a.S24.
Surgical site infections (SSIs) are a major source of morbidity after cardiac surgery, involving prolonged hospitalisation. Among the numerous techniques of skin closure and dressings available, the optimal method remains undetermined. The DERMABOND-PRINEO (PRINEO) (PRINEO, Ethicon, J&J) is the only skin closure system which combines a topical skin adhesive with a mesh. Other surgical disciplines have highlighted remarkable results with PRINEO. The aim of this study was to evaluate the effects of PRINEO, used as the final layer in sternotomy closure, in the incidence of postoperative SSIs.
This was a retrospective single-centre cohort study including adult patients who underwent cardiac surgery between January 2015 and December 2018. Patients who had undergone heart transplantation or ventricular assist surgery were excluded. Included patients were divided into two groups depending on the type of post-operative wound care technique used. Group 1 consisted of patients who had their sternotomy closed with a standard dressing and group 2 consisted of patients who were treated with PRINEO. The primary endpoint of our study was the occurrence of SSIs and secondary outcomes were the length of hospitalisation and mortality.
A total of 1603 patients were reviewed with the occurrence of 44 SSIs. Both groups were homogeneous in terms of risk factors. The incidence of SSIs was significantly lower in group 2 (PRINEO) than in group 1 (standard dressing) (n=29, 3.8% vs n=15, 1.8%, respectively; p=0.042). However, there was no significant difference in the duration of hospitalisation and mortality.
In our practice, PRINEO has proven to be a safe wound closure system after sternotomy, with a reduced SSI rate compared to conventional wound care techniques.
心脏手术后的手术部位感染（SSI）是发病率的主要来源，会导致住院时间延长。在众多可用的皮肤闭合和敷料技术中，最佳方法仍未确定。 Dermabond-PRINEO（PRINEO）（PRINEO，Ethicon，J&J）是唯一一种将局部皮肤粘合剂与网片结合在一起的皮肤闭合系统。其他外科学科已经强调了 PRINEO 的显著效果。本研究旨在评估 PRINEO 在胸骨切开术闭合中的应用作为术后 SSI 发生率的影响。
这是一项回顾性单中心队列研究，纳入了 2015 年 1 月至 2018 年 12 月期间接受心脏手术的成年患者。排除接受心脏移植或心室辅助手术的患者。根据术后伤口护理技术的类型，将纳入患者分为两组。第 1 组为胸骨切开术用标准敷料闭合的患者，第 2 组为接受 PRINEO 治疗的患者。本研究的主要终点是 SSI 的发生，次要终点是住院时间和死亡率。
共回顾了 1603 例患者，发生了 44 例 SSI。两组的危险因素均相似。第 2 组（PRINEO）的 SSI 发生率明显低于第 1 组（标准敷料）（n=29，3.8% vs n=15，1.8%，p=0.042）。然而，两组的住院时间和死亡率没有显著差异。
在我们的实践中，PRINEO 已被证明是胸骨切开术后安全的伤口闭合系统，与传统的伤口护理技术相比，SSI 发生率降低。
