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Impact of vacuum-assisted closure device in the treatment of sternal wound infection

Objective The aim of this study was to evaluate the effectiveness and clinical outcome of vacuum-assisted closure (VAC) therapy in the treatment of sternal wound infection (SWI) as either a sole therapy or as a bridge for other reconstructive procedures. Background VAC therapy is a novel treatment employed to aid wound healing in different areas of the body and recently also in SWI after cardiac surgeries. Patients and methods Our study is a prospective nonrandomized study conducted on 30 patients who developed either superficial or deep SWI after cardiac surgeries. These patients were undergoing VAC therapy as a sole therapy or as a bridge for other reconstructive procedures. Results The mean duration of VAC therapy was 12.7 (range: 4–27) days. The mean length of hospital stay was 27 (range 14–65) days.Twenty-nine (95%) patients were treated successfully. Hospital mortality occurred in one (3.33%) patient because of septic shock and multiple organ failure. At the end of VAC therapy, the mean reduction in wound size was 34.3%. The mean granulation tissue formation was 64%. VAC therapy was used as definitive therapy in 63.33% and as a bridge to conventional methods in 33.3% of cases. Conclusion VAC is a safe, reliable, and relatively new option for the treatment of devastating SWI after cardiac surgery. It is important to find a strategy that may be used as a 'standard VAC therapy approach' if identified in the future. Finally, we conclude that VAC therapy should be considered as a first-line treatment for most SWI.