Negative Pressure versus Conventional Sternal Wound Dressing in Coronary Surgery Using Bilateral Internal Mammary Artery Grafts

Vito Giovanni Ruggieri, Maud Emmanuelle Olivier, Chadi Aludaat, Stefano Rosato, Paul Marticho, Yves Assad Saade, Annick Lefebvre, Anne Poncet, Sylvain Rubin, Fausto Biancari

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Sternal wound infection (SWI) is a major complication occurring often after coronary artery bypass grafting (CABG) using bilateral internal mammary artery (BIMA) grafts. The aim of this study is to assess whether such a risk may be reduced by using incision negative pressure wound therapy (INPWT). Methods: Data on patients undergoing isolated CABG using BIMA grafts at the Reims University Hospital, France, from 2013 to 2016 without or with INPWT was prospectively collected. Results: INPWT was used in 161 patients and conventional sterile wound dressing was used in 266 patients. Propensity score matching resulted in 128 pairs with similar characteristics. SWIs were similarly distributed between the conventional sterile wound dressing (10.9%) and the INPWT cohorts (10.2%) (P = 1.00). Patients treated with INPWT had a lower rate of deep SWI/mediastinitis than patients who had conventional sterile dressing (5.5% versus 10.2%, P = .210), but the difference did not reach statistical significance. Tests for interaction confirmed these findings in different patient subgroups. Conclusion: The routine use of INPWT may not significantly reduce the risk of SWI in patients undergoing BIMA grafting. In view of previous reports showing a benefit with the use of this method, a large randomized study is justified to assess the efficacy of INPWT in patients undergoing cardiac surgery.

Original languageEnglish
Pages (from-to)E92-E96
JournalHeart Surgery Forum
Volume22
Issue number2
DOIs
Publication statusPublished - 2019

Keywords

  • Coronary surgery
  • sternal wound dressing
  • Bilateral internal mammary artery grafting

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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