A Comparative Analysis of Negative Pressure Wound Therapy Methods for Sternal Wound Infections

Abstract

Sternal wound infection can be a severe complication of cardiac surgery. Multiple debridements are often necessary before definitive coverage, and negative pressure wound therapy (NPWT) is often used as a temporary dressing between debridements. NPWT with instillation and dwell (NPWT-i) has been used in many wound types including sternal wounds with success. The purpose of this study was to compare outcomes between sternal wounds managed with conventional NPWT and NPWT-i. A total of 47 patients who had sternal wound infections were managed with debridement, negative pressure therapy, and flap. Patients were divided into 2 groups based on the type of negative pressure therapy: NPWT (n = 24) and NPWT-i (n = 23). The NPWT group required 3.3 debridements per patient before flap coverage, whereas the NPWT-i group required 3.4 debridements per patient (P = 0.86). Other postoperative outcomes including seroma, hematoma, delayed wound healing, and surgical site infection were similar between the 2 groups. We found NPWT similar to NPWT-i for the number of debridements needed and outcomes in the management of sternal wound infections. NPWT-i does not replace or decrease the need for operative debridement in sternal wounds.