Khirurgiia · 2026
[Wound infection management in early period after sternotomy].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Vinokurov I A, Tagabilev D G, Lev G V, Yusupov S A, Serebrennikova Yu A, Allau A A, Belov Yu V
Аннотация
OBJECTIVE: To describe appropriate treatment strategy at the Petrovsky National Research Center of Surgery and compare results for stable chest and sternum diastasis.
MATERIAL AND METHODS: Treatment results were analyzed in 91 patients between October 2022 and December 2024. Patients with sternum diastasis < 4 mm were assigned to group 1 (n=21), patients with severe diastasis - group 2 (n=70). In group 1, negative pressure therapy followed by secondary sutures was used, in group 2 - extended necrectomy with wound defect closure by muscle flaps.
RESULTS: In group 1, 5 (23.8%) patients had no clinical effect from therapy and required necrectomy and wound repair. Mortality rate was 4.8% and 8.6% (p=0.56), early recurrence of infection - 9.5% and 22.8% (p=0.18), mean hospital-stay - 10.1±3.6 and 19.8±5.4 days (p=0.03), respectively. Two-year survival was about 95% in both groups, and incidence of infection recurrence was higher in group 2 (23% after 2 years).
CONCLUSION: Chest wall stability may be decisive in choosing treatment strategy. Vacuum therapy is effective in patients without sternal diastasis. Mortality rate in early and long-term period after treatment was comparable in both groups.
MATERIAL AND METHODS: Treatment results were analyzed in 91 patients between October 2022 and December 2024. Patients with sternum diastasis < 4 mm were assigned to group 1 (n=21), patients with severe diastasis - group 2 (n=70). In group 1, negative pressure therapy followed by secondary sutures was used, in group 2 - extended necrectomy with wound defect closure by muscle flaps.
RESULTS: In group 1, 5 (23.8%) patients had no clinical effect from therapy and required necrectomy and wound repair. Mortality rate was 4.8% and 8.6% (p=0.56), early recurrence of infection - 9.5% and 22.8% (p=0.18), mean hospital-stay - 10.1±3.6 and 19.8±5.4 days (p=0.03), respectively. Two-year survival was about 95% in both groups, and incidence of infection recurrence was higher in group 2 (23% after 2 years).
CONCLUSION: Chest wall stability may be decisive in choosing treatment strategy. Vacuum therapy is effective in patients without sternal diastasis. Mortality rate in early and long-term period after treatment was comparable in both groups.