Negative pressure wound therapy for mediastinitis reduces the reinfection rate of the sternum

Objectives: Deep sternal wound infection is still a major complication in cardiac surgery. We compared the sternal reinfection rate in patients with poststernotomy mediastinitis after negative pressure wound therapy (NPWT) and conventional treatment. Methods: We retrospectively analyzed 118 patients with poststernotomy mediastinitis after cardiac surgery. One group of 69 patients were treated with NPWT and the other group of 49 patients with conventional therapy. Results: There were no major differences between the two groups concerning preoperative data (EuroScore) or primary cardiac surgery (mainly coronary artery bypass grafting). NPWT significantly reduced the sternal reinfection rate (P=0.0044) as compared to conventional treatment. Conclusion: NPWT of poststernotomy mediastinitis demonstrates encouraging clinical results with a reduction of the sternal re-infection rate compared to conventional treatment. The results support NPWT as the first-line treatment for deep sternal wound infections. Fig. 1 Black polyurethane foam sealed with an adhesive airtight drape in a sternal wound. The „suction pad“ is placed and the tube is connected to a vacuum source.