The Effect of Ultrasound-Assisted Debridement Combined with Vacuum Pump Therapy in Deep Sternal Wound Infections

• Published in: Annals of Thoracic and Cardiovascular Surgery 2018, Vol.24(3), pp.139-146
• Main Authors: Tewarie, Lachmandath, Chernigov, Nikolay, Goetzenich, Andreas, Moza, Ajay, Autschbach, Rüdiger, Zayat, Rashad
• Format: Article
• Language: English
• Subjects: cardiac surgery; Original; postoperative complications; sternal wound infection; ultrasonic-assisted wound debridement; vacuum-assisted wound closure
• ISSN: 1341-1098; 2186-1005
• DOI: 10.5761/atcs.oa.17-00244

Purpose: To assess whether a combined treatment of low-frequency (25 kHz) ultrasonic-debridement systems followed by vacuum-assisted wound closure (VAC) produces a better outcome in deep sternal wound infections (SWIs) compared to that of VAC alone.Methods: We evaluated 45 consecutive patients (25 males) between January 2013 and December 2016, in whom deep SWI was treated with a combination of low-frequency ultrasonic debridement system followed by vacuum-assisted closure (group A, n = 23) or with only vacuum-assisted closure therapy (group B, n = 22). Our final step in both groups was a secondary wound closure with a musculocutaneous flap.Results: In both groups, a similar variety of bacteria were isolated. The time between eradication and secondary wound closure was significantly shorter in group A (7.3 ± 4.8 vs. 19.9 ± 17.2 days, p = 0.001). After a third debridement session, 95.7% of microbiological cultures were negative in group A versus 54.5% in B ( p = 0.001). Duration of antibiotic treatment ( p = 0.003) and hospitalization time ( p = 0.0001) were significantly shorter in group A.Conclusion: The use of low-frequency ultrasonic debridement system is an effective, less invasive technique to combat wound infection. In combination with vacuum-assisted closure therapy, we documented good mid-term results in our patients.