Our Summary

This research paper is about a study that was conducted to see if a new wound care method could help reduce infection rates after heart surgery. The method in question is called Negative Pressure Wound Therapy (NPWT).

During heart surgery, one common method is to split the breastbone, or sternum, down the middle. This is called a median sternotomy. Unfortunately, infections in this area can sometimes occur after the operation, which can be serious and even fatal.

The researchers looked at infection rates before and after implementing a new wound care protocol, which included the use of NPWT. They found that the rate of infection within 90 days of the operation went down from 3.0% to 0.8% after introducing this new protocol.

They concluded that having a standardized wound care process, which includes the use of NPWT for all patients undergoing heart surgery with a median sternotomy, was a good way to help prevent infections in the sternum.

FAQs

  1. What is the primary endpoint of the study regarding sternotomy and sternal wound infections?
  2. How effective was the use of a universal wound care protocol with negative pressure wound therapy in preventing sternal infections post-sternotomy?
  3. How was the rate of sternal infection within 90 days of operation affected by the implementation of the universal wound care protocol?

Doctor’s Tip

A doctor might tell a patient undergoing sternotomy to make sure to follow a standardized wound care protocol, which may include the use of negative pressure wound therapy, to help prevent sternal infections and promote proper healing.

Suitable For

Patients undergoing cardiac surgery with median sternotomy are typically recommended sternotomy. This study suggests that the use of negative pressure wound therapy as part of a standardized wound care protocol can help prevent sternal wound infections in these patients.

Timeline

Before Sternotomy:

  1. Patient undergoes pre-operative evaluation and assessment.
  2. Patient is prepared for surgery, including fasting and pre-operative medications.
  3. Patient is taken to the operating room and given anesthesia.
  4. Surgeon makes an incision along the sternum to access the heart or chest cavity.
  5. Surgery is performed, which may involve procedures such as coronary artery bypass grafting or heart valve repair.
  6. Sternum is closed with sutures or wires.

After Sternotomy:

  1. Patient is taken to the recovery room for monitoring and pain management.
  2. Patient may stay in the hospital for several days for post-operative care.
  3. Patient is monitored for signs of infection, such as fever or increased pain at the incision site.
  4. If infection is suspected, patient may undergo diagnostic testing such as blood cultures or wound swabs.
  5. Treatment for sternal infection may involve antibiotics, wound care, or surgical debridement.
  6. Patient may require additional hospitalization or outpatient follow-up for wound healing and infection management.

What to Ask Your Doctor

  1. How common are sternal wound infections following median sternotomy?
  2. What are the risk factors for developing a sternal wound infection?
  3. How does negative pressure wound therapy work in preventing sternal infections?
  4. What is the success rate of using negative pressure wound therapy in preventing sternal infections?
  5. What are the potential complications or side effects of using negative pressure wound therapy?
  6. How long would I need to use negative pressure wound therapy after my surgery?
  7. Are there any alternative methods or treatments for preventing sternal infections?
  8. How will my recovery and healing process be affected by using negative pressure wound therapy?
  9. How often will I need to follow up with you or a wound care specialist during my recovery?
  10. What should I do if I notice any signs of infection or complications in my sternal wound during my recovery?

Reference

Authors: Traylor LB, Bhatia G, Blackhurst D, Wallenborn G, Ewing A, Bolton W, Davis B. Journal: Am J Surg. 2023 Dec;226(6):762-767. doi: 10.1016/j.amjsurg.2023.07.016. Epub 2023 Jul 11. PMID: 37453803