Major bleeding during negative pressure wound/V.A.C.® - therapy for postsurgical deep sternal wound infection - a critical appraisal

Journal of Cardiothoracic Surgery

Lilian Jekel³  Patrique Segers¹  Jan J van Wingerden² 

[1] Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam, the Netherlands;Department of Plastic- and Reconstructive Surgery, Academic Medical Center, University of Amsterdam, the Netherlands;Department of Cardiothoracic Surgery, Medisch Centrum Leeuwarden, Leeuwarden, the Netherlands

关键词: Wound infection;    Ventricle right;    Sternum;    Statistics meta-analysis;    Shock circulatory;    Negative pressure;    Mediastinal infection;    Mediastinitis;    Chest wall;    Bleeding emergency;   

Others  :  1153851
DOI  :  10.1186/1749-8090-6-121

 received in 2011-07-17, accepted in 2011-09-29,  发布年份 2011

【 摘 要 】

Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.^®) therapy, has become one of the most popular (and efficacious) interim (prior to flap reconstruction) or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate) decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.

【 授权许可】

   
2011 van Wingerden et al; licensee BioMed Central Ltd.

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