Skip to main content

Advertisement

SpringerLink
Log in

Efficacy of vacuum-assisted closure therapy on rehabilitation during the treatment for surgical site infection after cardiovascular surgery

  • Original Article
  • Published:
General Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Objective

Surgical site infection (SSI) after cardiovascular procedures is a severe complication, potentially leading to high morbidity and mortality. In addition, during the treatment of SSI, rehabilitation is delayed, which can severely impair postoperative recovery. The aim of this study was to assess the effect of vacuum-assisted closure (VAC) therapy on rehabilitation during the treatment of SSI after cardiovascular surgery.

Methods

From January 2008 to March 2015, 10 patients underwent VAC therapy for SSI after cardiovascular operations. The patient characteristics, duration of VAC therapy, time interval from the implementation of VAC to physical therapy (PT) (T1), ambulation (T2) and walking (T3), functional independent measure (FIM), and maximum consecutive walking capacity (MCWC) were retrospectively analyzed.

Results

Nine patients underwent mid-sternal incision and one patient underwent thoraco-abdominal incision. The mean time interval from the beginning of VAC therapy to PT, ambulation, and walking was 0.38 ± 0.50, 0.63 ± 0.71, and 1.38 ± 1.86 days, respectively. The average FIM was 84.5 ± 14.0 at the beginning of VAC therapy and 106.7 ± 18.5 at the end of VAC therapy (P = 0.000494). On average, MCWC was 52.3 ± 54.6 m at the installation of VAC therapy and 189.7 ± 152.8 m at the completion of VAC therapy (P = 0.0169). FIM and MCWC improvement rate was better in VAC group than non-VAC group although these data are not suitable for statistical analysis because of a small sample size.

Conclusions

Although further studies are warranted, VAC therapy may have a role in facilitating rehabilitation and improving the prognosis of SSI cases after major cardiovascular operations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Simek M, Nemec P, Zalesak B, Kalab M, Hajek R, Jecminkova L, Kolar M. Vacuum-assisted closure in the treatment of sternal wound infection after cardiac surgery. Biomed Pap Med Univ Palacky Olomouc Czech Repub. 2007;151(2):295–9.

    Article  Google Scholar 

  2. Vos RJ, Yilmaz A, Sonker U, Kelder JC, Kloppenburg GTL. Vacuum-assisted closure of post-sternotomy mediastinitis as compared to open packing. Interact Cardiovasc Thorac Surg. 2012;14:17–21.

    Article  PubMed  Google Scholar 

  3. Finkelstein R, Rabino G, Mashiah T, et al. Surgical site infection rates following cardiac surgery: the impact of a 6-year infection control program. Am J Infect Control. 2005;33:450–4.

    Article  PubMed  Google Scholar 

  4. Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep sternal wound complications: incidence, risk factor and mortality. Eur J Cardiothorac Surg. 2001;20:1168–75.

    Article  CAS  PubMed  Google Scholar 

  5. Suzuki T, Kawamoto Shunsuke, Motoyoshi N, Akiyama M, Kumagai K, Adachi O, Hayatsu Y, Ito K, Matsuo S, Saiki Y. Contemporary outcome of the surgical management of prosthetic graft infection after a thoracic aortic replacement: is there a room to consider vacuum-assisted wound closure as an alternative? Gen Thorac Cardiovasc Surg. 2015;63:86–92.

    Article  PubMed  Google Scholar 

  6. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control. 1999;27:97–132.

    Article  CAS  PubMed  Google Scholar 

  7. Fuchs U, Zittermann A, Stuetten B, Groening A, Minami K, Koefer R. Clinical outcome of patients with deep sternal infection managed by vacuum-assisted closure compared to conventional therapy with open packing: a retrospective analysis. Ann Thorac Surg. 2005;79:526–31.

    Article  PubMed  Google Scholar 

  8. Fleck TM, Fleck M, Moidl R, et al. The vacuum-assisted closure system for the treatment of deep sternal wound infection after cardiac surgery. Ann Thorac Surg. 2002;74:1596–600.

    Article  PubMed  Google Scholar 

  9. Immer FF, Durrer M, Muehlemann KS, Erni D, Galh B, Carrel TP. Deep sternal infection after cardiac surgery: modality of treatment and outcome. Ann Thorac Surg. 2005;80:957–61.

    Article  PubMed  Google Scholar 

  10. Sjogren J, Malmsjo M, Gustafsson R, Ingemansson R. Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm. Eur J Cardiothorac Surg. 2006;30:898–905.

    Article  PubMed  Google Scholar 

  11. Sjogren J, Gustafsson R, Nilsson J, Malmsjo M, Ingemansson R. Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment. Ann Thorac Surg. 2005;79:2049–55.

    Article  PubMed  Google Scholar 

  12. Higashita R, Asai T, Shiraishi S, Matsubayashi K, Nishi T, Kurokawa M. Vacuum-assisted closure for infections after cardiovascular surgery. Jpn J Cardiovasc Surg. 2006;35:127–31.

    Article  Google Scholar 

  13. Wackenfors A, Sjoegren J, Gustafsson R, Algotsson L, Ingemannsson R, Malmsjo M. Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow. Wound Repair Regen. 2004;12:600–6.

    Article  PubMed  Google Scholar 

  14. Kawata M, Nishimura T, Hoshino Y, Kinoshita O, Hisagi M, Ando M, Morota T, Motomura N, Kyo S, Ono M. Negative pressure wound therapy for left ventricular assist device-related mediastinitis: two case reports. J Artif Organs. 2011;14(2):159–62.

    Article  PubMed  Google Scholar 

  15. Kinoshita O, Nishimura T, Kawata M, Ando M, Kyo S, Ono M. Vacuum-assisted closure with Safetac technology for mediastinitis in patients with a ventricular assist device. J Artif Organs. 2010;13(2):126–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, 1187-299, Kaname, Tsukuba, Ibaraki, 300-2622, Japan

    Akihiro Yoshimoto, Takafumi Inoue, Masayuki Fujisaki, Sei Morizumi & Yoshihiro Suematsu

Authors
  1. Akihiro Yoshimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Takafumi Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masayuki Fujisaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sei Morizumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshihiro Suematsu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Akihiro Yoshimoto.

Ethics declarations

Conflicts of interest

All the authors declare that no conflicts of interest exist.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yoshimoto, A., Inoue, T., Fujisaki, M. et al. Efficacy of vacuum-assisted closure therapy on rehabilitation during the treatment for surgical site infection after cardiovascular surgery. Gen Thorac Cardiovasc Surg 64, 464–469 (2016). https://doi.org/10.1007/s11748-016-0664-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11748-016-0664-x

Keywords

Search

Navigation