Negative Pressure Wound Therapy: Comparison of Outpatient and Inpatient Approaches

Surg Technol Int. 2023 Sep 15:42:188-192. doi: 10.52198/23.STI.42.CV1658.

Abstract

Background: The results of recent studies regarding the efficacy of Negative Pressure Wound Therapy (NPWT) for the prevention of sternal wound infection (SWI) after adult cardiac surgery are not conclusive.

Methods: Data were collected from patients who were operated upon at the GVM Care & Research group in Italy from 2013 to 2021; all patients who required treatment for sternotomy wound infection with Negative Pressure Wound Therapy (NPWT) through WaterLily™ system (Eurosets, Medolla, MO, Italy) were selected. We compared the preoperative risk characteristics, and particularly those that were most strongly associated with possible dehiscence of the wound. A statistical analysis was performed for comparison of the groups.

Results: Out of the total 40,267 patients who underwent cardiac surgery with extracorporeal circulation within this time frame, 1,483 (3.68%) required NPWT, including 690 (46.52%) in the HOME group and 793 (53.47%) in the HOSPITAL group (p =0.76). Thirty-nine (5.65%) patients in the HOME group and 37 (4.66%) in the HOSPITAL group required re-treatment for re-dehiscence after secondary closure (p =0.79).

Conclusions: The use of a WaterLily™ system (Eurosets, Medolla, MO, Italy) was safe and effective for the treatment of sternotomy wounds with superficial and deep infections and was associated with a low rate of dehiscence, even when used with discharged and managed outpatient patients.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Cardiac Surgical Procedures / adverse effects
  • Cardiac Surgical Procedures / methods
  • Cardiac Surgical Procedures / statistics & numerical data
  • Female
  • Humans
  • Inpatients / statistics & numerical data
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy* / instrumentation
  • Negative-Pressure Wound Therapy* / methods
  • Negative-Pressure Wound Therapy* / statistics & numerical data
  • Outpatients / statistics & numerical data
  • Retrospective Studies
  • Sternotomy / adverse effects
  • Sternotomy / statistics & numerical data
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / prevention & control