Vacuum-assisted closure system in newborns after cardiac surgery

Objective To analyze the effectiveness and the results of the use of a vacuum-assisted closure (VAC) system for the treatment of complex sternal wounds in newborns after cardiac surgery. Methods From May 2008 until December 2012, six patients developed post-sternotomy wound problems (large defects of epithelialization or mediastinitis), which were treated with a VAC system. Median age at the time of institution of VAC was 24.5 days (range 16 to 65 days). Median time of treatment was 14 days (range 3 to 42 days). Results All patients were newborns and all underwent delayed sternal closure after cardiac surgery. The indications for using the VAC system were: mediastinitis in two patients (33.3%) and impairment of healing without signs of infection in four (66.7%). All children after VAC therapy achieved healing of the sternal wound. VAC therapy was started with high negative pressures (-125-mmHg) continuously then switched to an intermittent modality in all patients. Conclusion VAC system with high negative pressure is safe, effective, and is a well-tolerated therapy in newborns with complex sternal wounds. doi: 10.1111/jocs.12463 (J Card Surg 2015;30:190-193)