Can post-sternotomy mediastinitis be prevented by a closed incision management system? Kann Mediastinitis bei Zustand nach Sternotomie durch einen Vakuumverband verhindert werden?

Abstract Post-sternotomymediastinitisisaseriouscomplicationaftercardio-thoracicsurgeryandcontributesignificantlytopost-operativemorbidity, PascalM.Dohmen 1 ThanasieMarkou 2 mortality,andhealthcarecosts.Negativepressurewoundtherapyistoday’sgoldenstandardforpost-sternotomymediastinitistreatment. RichardIngemansson 3 AsystematicliteraturesearchwasconductedatPubMeduntilOctober HeinrichRotering 4 2012toanalysewhethervacuum-assistedclosuretechniqueprevents JeanM.Hartman 5 mediastinitis after clean surgical incisions closure. Today’s studiesshowedreductionofpost-sternotomymediastinitisincludingabeneficial RenevanValen 6 socio-economicimpact.Currentstudies,howeverincludedonlyhigh- MaaikeBrunott 6 riskpatients,hencefurthermore,largerrandomisedcontrolledtrials AxelKramer 7 arewarrantedtoclarifythebenefitforusingsurgicalincisionvacuummanagementsystemsinthegeneralpatientpopulationundergoing PatriqueSegers 8 sternotomyandclarifyriskfactorinteraction.Keywords:incisionalnegativepressuretherapy,cardiothoracicsurgery,surgicalwounds,surgicalsiteinfection,closedincisionmanagement,negativepressurewoundtherapy(NPWT)