Initial Experience with Closed Incision Negative Pressure Therapy Specialty Dressing Over Sternal Reconstruction Incisions
Abstract
Following median sternotomy, surgical site complications (SSCs) such as sternal dehiscence have an incidence of 0.06% to 12.50%, with associated perioperative mortality as high as 47%. Closed incision negative pressure therapy (ciNPT) administers continuous subatmospheric pressure, removes fluid and infectious materials, holds incision edges together, provides a barrier to contaminants and reduces the incidence of edema. Recently, a ciNPT specialty dressing with an expanded coverage area was developed to protect incisions. We describe our experience using this ciNPT specialty dressing to help manage sternal reconstruction incisions in four patients.
The ciNPT specialty dressing was applied to incisions stemming from revised sternal dehiscences of patients (n=4) who had developed SSCs following index cardiothoracic procedures. Perioperative antibiotics were administered. A single surgeon performed debridement and chest wall reconstruction with bilateral pectoral flaps to revise the dehiscence. Incisions were stapled or sutured, and surgical drains were placed as necessary. Immediately postoperatively, the ciNPT specialty dressing was placed over the closed incision and ciNPT (-125 mmHg) was initiated. Dressing changes occurred every seven days.
In these patients, the ciNPT specialty dressing facilitated positive healing outcomes following the revision of a sternal dehiscence. These outcomes support the use of ciNPT specialty dressings in the management of sternal dehiscence incisions.
About the Presenter
Chungeun (Chloe) Lee
Chungeun (Chloe) Lee, B.S., is a second-year medical student at the Washington State University Elson S. Floyd College of Medicine. Prior to medical school, Chloe attended the University of Washington, where she majored in Neurobiology and minored in Bioethics. She then took two years in between college and medical school to volunteer and work. Chloe is currently planning to pursue a career in academic surgery. Her research interests focus on surgical and clinical outcomes, quality improvement, and healthcare innovation.