EXPERIENCE OF APPLICATION OF VACUUM-ASSISTED CLOSURE IN NEONATES WITH SUPERFICIAL POSTSTERNOTOMY WOUND INFECTION AFTER CARDIAC SURGERY
https://doi.org/10.24884/0042-4625-2017-176-2-62-65
Abstract
OBJECTIVE. The study evaluated the efficacy of application of the method of vacuum-assisted closure in neonates with complicated healing of sternotomy soft tissue wounds after cardiac surgery. MATERIALS AND METHODS. Vacuum-assisted therapy of soft tissue of the thorax was performed on 9 patients with poststernotomy wound infection. The patients were infants aged 1 to 27 days (mean age 6 days) with weight from 2,3 to 3,6 kg (mean value 3,2 kg). RESULTS. The time of revealing the signs of incompetence of soft tissues of the thorax numbered 5-9 days. The duration of vacuum drainage was 5-14 days (mean value 9 days). Given period allowed clinicians to reach the effective wound cleansing and healing without problems after secondary closure. CONCLUSIONS. The application of the method was effective and healing of soft tissues of sternotomy wound of infectious and noninfectious nature was carried out in short terms in neonates after cardiac interventions.
About the Authors
A. A. Morozov
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
E. V. Grekhov
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
A. K. Latypov
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
N. A. Kotin
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
A. V. Vasilets
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
I. A. Kozyrev
V.A. Almazov North-Western Federal Research Centre
Russian Federation
Russian Federation
References
1. Рузматов Т. М., Эфендиев В. У., Бобошко А. В., Малахов Е. С., Несмачный А. С., Разумахин Р. А., Карева Ю. Е., Чернявский А. М. Вакуумная терапия послеоперационного стерномедиастинита // Хирургия. 2015. № 8. С. 14-18.
2. Argenta L. C., Morykwas M. J. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience // Ann. Plast. Surg. 1997. Vol. 38. P. 563-577.
3. Calvat S., Trouillet J. L., Nataf P. et al. Closed drainage using Redon catheters for local treatment of poststernotomy mediastinitis // Ann. Thorac. Surg. 1996. Vol. 61. P. 195-201.
4. Durandy Y., Batisse A., Bourel P. et al. Mediastinal infection after cardiac operation: a simple closed technique // J. Thorac. Cardiovasc. Surg. 1989. Vol. 97. P. 282-285.
5. Erez E., Katz M., Sharoni E. et al. Pectoralis major muscle flap for deep sternal wound infection in neonates // Ann. Thorac. Surg. 2000. Vol. 69. P. 572-577.
6. Fleck T., Simon P., Burda G. et al. Vacuum assisted closure therapy for the treatment of sternal wound infections in neonates and small infants // Interact. Cardiovasc. Thorac. Surg. 2006. Vol. 5. P. 285-288.
7. ulian O. C., Lopez-Belio M., Dye W.A. et al. The median sternotomy incision in cardiac surgery with extracorporeal circulation // Surgery. 1957. Vol. 42. P. 753-761.
8. Kadohama T., Akasaka N., Nagamine A. et al. Vacuum-assisted closure for pediatric post-sternotomy mediastinitis: are low negative pressures sufficient? // Ann. Thorac. Surg. 2008. Vol.85. P. 1094-1096.
9. Mehta P.A., Cunningham C. K., Colella C. B. et al. Risk factors for sternal wound and other infections in pediatric cardiac surgery patients // Pediatr. Infect. Dis. J. 2000. Vol.19. P. 1000-1004.
10. Ohuchi S., Kawazoe K., Ishihara K. et al. Management with closed irrigation for post-sternotomy mediastinitis: experience with the use of electrolyzed strong acid aqueous solution // Jpan. J. Thorac. Cardiovasc. Surg. 2003. Vol. 51. P. 511-514.
11. Ohye R. G., Maniker R. B., Graves H. L. et al. Primary closure for postoperative mediastinitis in children // J. Thorac. Cardiovasc. Surg. 2004. Vol. 128. P. 480-486.
12. Salazard B., Niddam J., Ghez O. et al. Vacuum assisted closure in the treatment of poststernotomy mediastinitis in the pediatric patient // J. Plast. Reconstr. Aesthet. Surg. 2007. Vol. 61. P. 302- 305.
13. Shumacker H. B., Mandelbaum I. Continuous antibiotic irrigation in the treatment of infection // Arch. Surg. 1963. Vol. 86. P. 384-387.
14. Stiegel R. M., Beasley M. E., Sink J. D. et al. Management of postoperative mediastinitis in infants and children by muscle flap rotation // Ann. Thorac. Surg. 1988. Vol. 46. P. 45-46.
15. Sung K., Jun T. G., Park P. W. et al. Management of deep sternal infection in infants and children with advanced pectoralis major muscle flaps // Ann. Thorac. Surg. 2004. Vol. 77. P. 1371-1375.
16. Tortoriello T.A., Friedman J. D., McKenzie E. D. et al. Mediastinitis after pediatric cardiac surgery: a 15-year experience at a single institution // Ann. Thorac. Surg. 2003. Vol. 76. P. 165.
Review
For citations:
Morozov A.A., Grekhov E.V., Latypov A.K., Kotin N.A., Vasilets A.V., Kozyrev I.A. EXPERIENCE OF APPLICATION OF VACUUM-ASSISTED CLOSURE IN NEONATES WITH SUPERFICIAL POSTSTERNOTOMY WOUND INFECTION AFTER CARDIAC SURGERY. Grekov's Bulletin of Surgery. 2017;176(2):62-65. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-2-62-65
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