Prophylactic Application of Closed Incision Negative Pressure Therapy After High Risk Cardiothoracic Procedures: A Single Center Study

Evren Özçınar

Makale detayları

Prophylactic Application of Closed Incision Negative Pressure Therapy After High Risk Cardiothoracic Procedures: A Single Center Study

Yazarlar:

Evren Özçınar

Yayıncı:

Ankara University

Ana Başlıklar:

Cardiovascular Medicine and Haematology (Other)

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.77 Issue 2, pp.169-173

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001349761

pISSN:

0365-8104

Anahtar kelimeler:

Özet:

 Objectives: Sternal wound infections SWIs after cardiac surgery are devastating complications and cost loads for healthcare providers and vulnerable patients in the postoperative period after high-risk cardiothoracic operations. Although the prophylactic use of closed incision negative pressure therapy ciNPT is still controversial, recent studies report positive outcomes. Our study aims to identify the efficacy of ciNPT in ventricular assist device implantation procedures with focus on the hypothesis that the reduction rate of impaired healing and infection. Materials and Methods: We performed a retrospective study with 18 advanced heart failure patients after ventricular assist devices implantations. Conventional sterile gauze dressings were applied in the control group n10, while ciNPT Prevena system was applied in the study group. Patients demographics, risk factors such as diabetes mellitus, obesity, smoking, chronic obstructive pulmonary disease, Euroscore II and Fowler Risk score were documented. Wounds were examined instantly after removal of Prevena system on postoperative 6 to 8 days and on follow-up 45 days. Signs of infections and healing problems, inflammatory biomarkers were noted. Results: The number of ventricular assist device implantations were 18, with 10 in control and 8 in study group. Both groups were similar in all demographical characteristics. Driveline insertion site and superficial SWI rates were higher in control group than the study group p0.003 and p0.018, respectively. One superficial SWI was noted in the control group. No deep wound infections requiring debridement was observed in both groups. Length of hospital stay was longer in control group p0.05. Conclusion: We concluded that closed incision ciNPT has an impact on reducing driveline site infections, length of hospitalization and cost load for health care providers. This preliminary results appear to support the advantage of closed incision ciNPT application after ventricular assist device implantation procedures and serve as a basic information for more comprehensive studies.

 Objectives: Sternal wound infections SWIs after cardiac surgery are devastating complications and cost loads for healthcare providers and vulnerable patients in the postoperative period after high-risk cardiothoracic operations. Although the prophylactic use of closed incision negative pressure therapy ciNPT is still controversial, recent studies report positive outcomes. Our study aims to identify the efficacy of ciNPT in ventricular assist device implantation procedures with focus on the hypothesis that the reduction rate of impaired healing and infection. Materials and Methods: We performed a retrospective study with 18 advanced heart failure patients after ventricular assist devices implantations. Conventional sterile gauze dressings were applied in the control group n10, while ciNPT Prevena system was applied in the study group. Patients demographics, risk factors such as diabetes mellitus, obesity, smoking, chronic obstructive pulmonary disease, Euroscore II and Fowler Risk score were documented. Wounds were examined instantly after removal of Prevena system on postoperative 6 to 8 days and on follow-up 45 days. Signs of infections and healing problems, inflammatory biomarkers were noted. Results: The number of ventricular assist device implantations were 18, with 10 in control and 8 in study group. Both groups were similar in all demographical characteristics. Driveline insertion site and superficial SWI rates were higher in control group than the study group p0.003 and p0.018, respectively. One superficial SWI was noted in the control group. No deep wound infections requiring debridement was observed in both groups. Length of hospital stay was longer in control group p0.05. Conclusion: We concluded that closed incision ciNPT has an impact on reducing driveline site infections, length of hospitalization and cost load for health care providers. This preliminary results appear to support the advantage of closed incision ciNPT application after ventricular assist device implantation procedures and serve as a basic information for more comprehensive studies.

 Objectives: Sternal wound infections SWIs after cardiac surgery are devastating complications and cost loads for healthcare providers and vulnerable patients in the postoperative period after high-risk cardiothoracic operations. Although the prophylactic use of closed incision negative pressure therapy ciNPT is still controversial, recent studies report positive outcomes. Our study aims to identify the efficacy of ciNPT in ventricular assist device implantation procedures with focus on the hypothesis that the reduction rate of impaired healing and infection. Materials and Methods: We performed a retrospective study with 18 advanced heart failure patients after ventricular assist devices implantations. Conventional sterile gauze dressings were applied in the control group n10, while ciNPT Prevena system was applied in the study group. Patients demographics, risk factors such as diabetes mellitus, obesity, smoking, chronic obstructive pulmonary disease, Euroscore II and Fowler Risk score were documented. Wounds were examined instantly after removal of Prevena system on postoperative 6 to 8 days and on follow-up 45 days. Signs of infections and healing problems, inflammatory biomarkers were noted. Results: The number of ventricular assist device implantations were 18, with 10 in control and 8 in study group. Both groups were similar in all demographical characteristics. Driveline insertion site and superficial SWI rates were higher in control group than the study group p0.003 and p0.018, respectively. One superficial SWI was noted in the control group. No deep wound infections requiring debridement was observed in both groups. Length of hospital stay was longer in control group p0.05. Conclusion: We concluded that closed incision ciNPT has an impact on reducing driveline site infections, length of hospitalization and cost load for health care providers. This preliminary results appear to support the advantage of closed incision ciNPT application after ventricular assist device implantation procedures and serve as a basic information for more comprehensive studies.

 Amaç: Kalp cerrahisi sonrası sternal yara enfeksiyonları, özellikle yüksek riskli kardiyotorasik operasyonlardan sonraki postoperatif dönemde hastalar ve sağlık hizmeti sunucuları için önemli komplikasyonlara ve maliyet yüklerine neden olmaktadır. Profilaktik kapalı insizyon negatif basınç tedavisinin kullanımı halen tartışmalı olsa da, son yıllarda yapılan çalışmalarda olumlu sonuçlar bildirilmektedir. Çalışmamız, ventriküler destek sistemi implantasyonu prosedürleri sonrası kapalı insizyon negatif basınç tedavisinin etkinliğini, iyileşme sorunlarında ve enfeksiyon oranlarında azalma hipotezine odaklanarak sunmayı amaçlamaktadır. Gereç ve Yöntem: Çalışmamız, ileri evre kalp yetmezliği olan ve ventriküler destek cihazı implantasyonu yapılan 18 hastanın takip verilerine retrospektif olarak ulaşılarak gerçekleştirilmiştir. Kontrol grubuna n10 geleneksel steril gazlı bez pansumanları uygulanırken, çalışma grubuna kapalı insizyon negatif basınç tedavisi Prevena sistemi uygulanmıştır. Hastaların demografik özellikleri, diabetes mellitus, obezite, sigara kullanımı, kronik obstrüktif akciğer hastalığı gibi risk faktörleri, Euroscore II ve Fowler risk skorları kaydedilmiştir. İnsizyonlar, Prevena sistemininçıkarılmasından hemen sonra postoperatif 6 ila 8. günlerde ve 45. günde değerlendirilmiştir. Enfeksiyon belirtileri ve iyileşme sorunları, enflamatuvar biyobelirteçler kaydedilmiştir. Bulgular: Ventriküler destek cihazı implantasyonu yapılan hasta sayısı 10u kontrol, 8i çalışma grubunda olmak üzere 18 idi. Her iki grup da tüm demografik özellikler açısından benzerdi. Driveline hattı ve yüzeysel sternal yara enfeksiyonu oranları kontrol grubunda, çalışma grubuna göre daha yüksek saptandı sırasıyla p0,003 ve p0,018. Kontrol grubunda bir adet yüzeysel sternal yara yeri enfeksiyonu görüldü. Her iki grupta da debridman gerektiren derin yara yeri enfeksiyonu görülmedi. Hastanede kalış süresi kontrol grubunda daha uzundu p0,05. Sonuç: Bu çalışma ile kapalı insizyon negatif basınç tedavisinin driveline hattı enfeksiyonlarını, hastanede kalış süresini ve sağlık hizmetlerindeki maliyet yükünü azaltmada etkisi olduğu sonucuna varılmıştır. Bu ön sonuçların, ventriküler destek cihazı implantasyonu prosedürleri sonrasında profilaktik kapalı insizyon negatif basınç tedavisi uygulamasının avantajını desteklediği ve daha kapsamlı çalışmalar için temel bilgi teşkil ettiği görülmektedir.

Makale detayları

Prophylactic Application of Closed Incision Negative Pressure Therapy After High Risk Cardiothoracic Procedures: A Single Center Study

Yazarlar:

Evren Özçınar

Yayıncı:

Ankara University

Ana Başlıklar:

Cardiovascular Medicine and Haematology (Other)

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.77 Issue 2, pp.169-173

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001349761

pISSN:

0365-8104

Closed incisional negative pressure therapy

sternal driveline site infections

wound infections

wound therapyKapalı insizyon negatif basınç tedavisi

driveline hattı enfeksiyonları

yara enfeksiyonları

yara tedavisi

Sayı

Makale detayları

Yazarlar: Evren Özçınar

Yayıncı: Ankara University

Ana Başlıklar: Cardiovascular Medicine and Haematology (Other)

Dergi: Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.77 Issue 2, pp.169-173

Belge Tipi: Makale

Yayın Tarihi: 12/2024

Belge Dili: İngilizce

Document ID (Org No.): 2001349761

pISSN: 0365-8104

Sayı

Yazarlar:

Evren Özçınar

Yayıncı:

Ankara University

Ana Başlıklar:

Cardiovascular Medicine and Haematology (Other)

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.77 Issue 2, pp.169-173

Belge Tipi:

Makale

Yayın Tarihi:

12/2024

Belge Dili:

İngilizce

Document ID (Org No.):

2001349761

pISSN:

0365-8104