Treatment Outcomes of Postoperative Mediastinitis After Cardiac Surgery: A Comparison of Negative Pressure Wound Therapy Performed with Instillation Method and Non-Instillation Method

Öz

Objective: Mediastinitis following cardiac surgery is potentially devastating complication. Various treatment modalities were suggested for this clinical situation and vacuum assisted closure is one of them. In the study it was aimed to compare outcomes of vacuum assisted closure performed with instillation and non-instillation methods.
Materials and Methods: From January 2015 to June 2019, a total of 60 patients who had mediastinitis after cardiac surgery performed via sternotomy were included to the study. Both Group 1 and Group 2 was consisted of 30 patients to whom negative pressure wound therapy performed without and with instillation, respectively. Demographic characteristics and treatment outcomes were compared between the groups.
Results: Demographic data of the patients were similar. Bacteriologic cultures showed the presence of staphylococci in the majority of the patients in both groups (Group 1, 61.6%; Group 2, 70%). Duration of treatment, eradication of the infection, wound closure and patients discharge were statistically lower in Group 2 (p<0.05). Rate of the patients with healed wound was statistically significantly higher in Group 2 (p<0.05).
Conclusion: Vacuum assisted negative pressure therapy via instillation is a reliable method that can be performed in the treatment of mediastinitis and has superiority over non-instillation method. 

Anahtar Kelimeler

• Infection
• mediastinitis
• negative pressure wound therapy
• vacuum-assisted closure
• wound healing
• Infection
• mediastinitis
• negative pressure wound therapy
• vacuum-assisted closure
• wound healing
• Infection, mediastinitis, negative pressure wound therapy, vacuum-assisted closure, wound healing

Kardiyak Cerrahi Sonrası Postoperatif Mediastinit Tedavisi Sonuçları: Yıkamalı ve Yıkamasız Metodlarla Yapılan Negatif Basınçlı Yara Tedavilerinin Karşılaştırılması

Öz

Amaç: Kalp cerrahisi sonrası gelişen mediastinit potansiyel olarak yıkıcı bir komplikasyondur. Bu klinik durum için çeşitli tedavi modaliteleri önerilmiştir ve vakum yardımlı kapatma bunlardan biridir. Bu çalışmada yıkamalı ve yıkamasız yöntemlerle gerçekleştirilen vakum destekli kapatmanın sonuçlarını karşılaştırmayı amaçlanmıştır.
Materyal ve Metot: Ocak 2015-Haziran 2019 tarihleri ​​arasında sternotomi ile kalp cerrahisi gerçekleştirilen ve sonrasında mediastinit gelişen toplam 60 hasta çalışmaya dahil edildi. Grup 1 ve Grup 2, sırası ile yıkamasız ve yıkamalı negatif basınçlı yara tedavisi uygulanan 30 hastadan oluşturuldu. Gruplar arasında demografik özellikler ve tedavi sonuçları karşılaştırıldı.
Bulgular: Hastaların demografik verileri benzerdi. Bakteriyolojik kültürler, her iki gruptaki hastaların büyük çoğunluğunda stafilokok varlığını gösterdi (Grup 1, %61,6; Grup 2, %70). Tedavi, enfeksiyon eradikasyonu, yara kapanma ve hasta taburculuğu süreleri Grup 2'de istatistiksel olarak daha düşüktü (p<0,05) Yara kapanma oranı Grup 2'de istatistiksel olarak daha yüksekti (p<0,05).
Sonuç: Yıkama metodu kullanılarak uygulanan vakum destekli negatif basınç tedavisi, mediastinit tedavisinde uygulanabilen bir yöntemdir ve yıkamasız yönteme göre üstünlükleri mevcuttur. 

Anahtar Kelimeler

• Enfeksiyon
• mediastinit
• negatif basınçlı yara tedavisi
• vakum yardımlı kapatma
• yara iyileşmesi

Kaynakça

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