Prophylactic Application of Closed Incision Negative Pressure Therapy After High Risk Cardiothoracic Procedures: A Single Center Study

Objectives: Sternal wound infections (SWIs) after cardiac surgery are devastating complications and cost loads for healthcare providers and vulnerable patients in the postoperative period after high-risk cardiothoracic operations.Although the prophylactic use of closed incision negative pressure therapy (ciNPT) is still controversial, recent studies report positive outcomes.Our study aims to identify the efficacy of ciNPT in ventricular assist device implantation procedures with focus on the hypothesis that the reduction rate of impaired healing and infection. Materials and Methods:We performed a retrospective study with 18 advanced heart failure patients after ventricular assist devices implantations.Conventional sterile gauze dressings were applied in the control group (n=10), while ciNPT (Prevena™ system) was applied in the study group.Patients demographics, risk factors such as diabetes mellitus, obesity, smoking, chronic obstructive pulmonary disease, Euroscore II and Fowler Risk score were documented.Wounds were examined instantly after removal of Prevena™ system on postoperative 6 to 8 days and on follow-up 45 days.Signs of infections and healing problems, inflammatory biomarkers were noted. Results:The number of ventricular assist device implantations were 18, with 10 in control and 8 in study group.Both groups were similar in all demographical characteristics.Driveline insertion site and superficial SWI rates were higher in control group than the study group (p=0.003 and p=0.018, respectively).One superficial SWI was noted in the control group.No deep wound infections requiring debridement was observed in both groups.Length of hospital stay was longer in control group (p=0.05). Conclusion:We concluded that closed incision ciNPT has an impact on reducing driveline site infections, length of hospitalization and cost load for health care providers.This preliminary results appear to support the advantage of closed incision ciNPT application after ventricular assist device implantation procedures and serve as a basic information for more comprehensive studies.