Vacuum-assisted therapy with a handcrafted system for the treatment of wound infection after median sternotomy

Abstract

The VAC (vacuum-assisted closure) system is a non-invasive therapy based on the application of negative pressure by controlled suction to the wound surface. This method has been proved to be effective on the promotion of granulation tissue proliferation. The aim of the study was to evaluate the effectiveness of the vacuum-assisted therapy with a handcrafted system, because the commercialized one was not available in our institution. Since July 2004, seven patients with sternal wound infection after median sternotomy were treated with vacuum-assisted therapy. All patients underwent surgical debridement under aseptic conditions. Thereafter, the patients received vacuum-assisted therapy with a handcrafted system. Complete healing with a tension-free wound direct closure was achieved in all patients, without morbidity. Removal of the system was done after a median of 15 days after surgery (range 8-47 days). All patients received intravenous antibiotics during the treatment. The cultures became negative after a median of 7 days (range 2-21 days). We suggest that our method, based on the negative pressure principle, is a valuable and effective tool in the management of patients with wound infection after median sternotomy when the commercialized one is not available.