The impact of VAC Therapy on management of sternal wound infections after cardiac surgery
Sternal wound infection after cardiac surgery is a serious problem resulting in increased patient morbidity; mortality and duration of hospital stay (Luckraz et al 2003).
The incidence of this infection has been variably reported as 0.5 to 5% and the resultant mortality as 10 to 25% (Sjogren et al 2006; Schimer et al 2008). Conventionally, many management techniques have been recommended to treat this complication like surgical debridement with open dressings, closed irrigation of the infected wound, or reconstruction with vascularised omental or pectoral muscle flaps (Domkowski et al 2003). Vacuum assisted closure (VAC) therapy is one of the newer modalities to treat this complication (Evans & Land 1997) which has been widely adopted. Application of negative pressure was successfully used for treating chronic wounds such as diabetic foot ulcers (Eneroth & van Houtum 2008; Ubbink et al 2008). After it was found successful in achieving faster healing in these wounds, use of this therapy has been extended for the management of sternal wound infections as well (Luckraz et al 2003; Domkowski et al 2003; Hersh et al 2003; Sjogren et al 2006). However, it hasn’t been proven yet with good evidence that its efficacy is more than the conventional treatment. Thus, the main objective of this review is to determine the effectiveness of vacuum assisted closure therapy in the management of wound infection after cardiac surgery.