The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 5 , Pages 1007-1013 , May 2008

Topical negative pressure therapy of a sternotomy wound increases sternal fluid content but does not affect internal thoracic artery blood flow: Assessment using magnetic resonance imaging

  • Rainer Petzina, MD

      Affiliations

    • Department of Medicine, Lund University Hospital, Lund, Sweden
    • Deutsches Herzzentrum Berlin, Berlin, Germany
  • ,
  • Martin Ugander, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University Hospital, Lund, Sweden
  • ,
  • Lotta Gustafsson, MSc, PhD

      Affiliations

    • Department of Medicine, Lund University Hospital, Lund, Sweden
  • ,
  • Henrik Engblom, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University Hospital, Lund, Sweden
  • ,
  • Roland Hetzer, MD, PhD

      Affiliations

    • Deutsches Herzzentrum Berlin, Berlin, Germany
  • ,
  • Håkan Arheden, MD, PhD

      Affiliations

    • Department of Clinical Physiology, Lund University Hospital, Lund, Sweden
  • ,
  • Richard Ingemansson, MD, PhD

      Affiliations

    • Department of Cardiothoracic Surgery, Lund University Hospital, Lund, Sweden
  • ,
  • Malin Malmsjö, MD, PhD

      Affiliations

    • Department of Medicine, Lund University Hospital, Lund, Sweden
    • Corresponding Author InformationAddress for reprints: Malin Malmsjö, MD, PhD, Vascular Research, Lund University, BMC A13, SE-221 84 Lund, Sweden.

Received 28 May 2007 ,Revised 9 August 2007 ,Accepted 12 September 2007.

References 

  1. Lu X, Chen S, Li X, et al. The experimental study of the effects of vacuum-assisted closure on edema and vessel permeability of the wound. Chin J Clin Rehab. 2003;7:1244–1245
  2. Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep sternal wound complications: incidence, risk factors and mortality. Eur J Cardiothorac Surg. 2001;20:1168–1175
  3. Ståhle E, Tammelin A, Bergström R, Hambreus A, Nyström SO, Hansson HE. Sternal wound complications—incidence, microbiology and risk factors. Eur J Cardiothorac Surg. 1997;11:1146–1153
  4. Borger MA, Rao V, Weisel RD, Ivanov J, Cohen G, Scully HE, et al. Deep sternal wound infection: risk factors and outcomes. Ann Thorac Surg. 1998;65:1050–1056
  5. Grossi EA, Culliford AT, Krieger KH, Kloth D, Press R, Baumann FG, et al. A survey of 77 major infectious complications of median sternotomy: a review of 7,949 consecutive operative procedures. Ann Thorac Surg. 1985;40:214–223
  6. Krabatsch T, Fleck E, Hetzer R. Treating poststernotomy mediastinitis by transposition of the greater omentum: late angiographic findings. J Card Surg. 1995;10:46–51
  7. Durandy Y, Batisse A, Bourel P, Dibie A, Lemoine G, Lecompte Y. Mediastinal infection after cardiac operation: a simple closed technique. J Thorac Cardiovasc Surg. 1989;97:282–285
  8. Lee AB, Schimert G, Shaktin S, Seigel JH. Total excision of the sternum and thoracic pedicle transposition of the greater omentum; useful strategems in managing severe mediastinal infection following open heart surgery. Surgery. 1976;80:433–436
  9. Shibata T, Hattori K, Hirai H, Fujii H, Aoyama T, Seuhiro S. Rectus abdominis myocutaneous flap after unsuccessful delayed sternal closure. Ann Thorac Surg. 2003;76:956–958
  10. Domkowski PW, Smith ML, Gonyon DL, Drye C, Wooten MK, Levin LS, et al. Evaluation of vacuum-assisted closure in the treatment of poststernotomy mediastinitis. J Thorac Cardiovasc Surg. 2003;126:386–390
  11. Mokhtari A, Petzina R, Gustafsson L, Sjögren J, Malmsjö M, Ingemansson R. Sternal stability at different negative pressures during vacuum-assisted closure therapy. Ann Thorac Surg. 2006;82:1063–1067
  12. Fleck TM, Fleck M, Moidl R, Czerny M, Koller R, Giovanoli P, et al. The vacuum-assisted closure system for the treatment of deep sternal wound infections after cardiac surgery. Ann Thorac Surg. 2002;74:1596–1600discussion 1600
  13. Doss M, Martens S, Wood JP, Wolff JD, Baier C, Moritz A. Vacuum-assisted suction drainage versus conventional treatment in the management of poststernotomy osteomyelitis. Eur J Cardiothorac Surg. 2002;22:934–938
  14. Sjögren J, Gustafsson R, Nilsson J, Malmsjö M, Ingemansson R. Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment. Ann Thorac Surg. 2005;79:2049–2055
  15. Sjögren J, Nilsson J, Gustafsson R, Malmsjö M, Ingemansson R. The impact of vacuum-assisted closure on long-term survival after post-sternotomy mediastinitis. Ann Thorac Surg. 2005;80:1270–1275
  16. Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38:563–576discussion 577
  17. Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997;38:553–562
  18. Petzina R, Gustafsson L, Mokhtari A, Ingemansson R, Malmsjö M. Effect of vacuum-assisted closure on blood flow in the peristernal thoracic wall after internal mammary artery harvesting. Eur J Cardiothorac Surg. 2006;30:85–89
  19. Wackenfors A, Gustafsson R, Sjögren J, Algotsson L, Ingemansson R, Malmsjö M. Blood flow responses in the peristernal thoracic wall during vacuum-assisted closure therapy. Ann Thorac Surg. 2005;79:1724–1730discussion 1730–1
  20. Chatzimavroudis GP, Zhang H, Halliburton SS, Moore JR, Simonetti OP, Schvartzman PR, et al. Clinical blood flow quantification with segmented k-space magnetic resonance phase velocity mapping. J Magn Reson Imaging. 2003;17:65–71
  21. Timmers MS, Le Cessie S, Banwell P, Jukema GN. The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg. 2005;55:665–671
  22. Chen SZ, Li J, Li XY, Xu LS. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg. 2005;28:211–217
  23. Urschel JD, Scott PG, Williams HT. The effect of mechanical stress on soft and hard tissue repair; a review. Br J Plast Surg. 1988;41:182–186
  24. Pennell DJ, Sechtem UP, Higgins CB, Manning WJ, Pohost GM, Rademakers FE, et al. Clinical indications for cardiovascular magnetic resonance (CMR): Consensus Panel report. Eur Heart J. 2004;25:1940–1965
  25. Arheden H, Saeed M, Törnqvist E, Lund G, Wendland MF, Higgins CB, et al. Accuracy of segmented MR velocity mapping to measure small vessel pulsatile flow in a phantom simulating cardiac motion. J Magn Reson Imaging. 2001;13:722–728
  26. Kuehne T, Yilmaz S, Schulze-Neick I, Wellnhofer E, Ewert P, Nagel E, et al. Magnetic resonance imaging guided catheterisation for assessment of pulmonary vascular resistance: in vivo validation and clinical application in patients with pulmonary hypertension. Heart. 2005;91:1064–1069
  27. Miller Q, Bird E, Bird K, Meschter C, Moulton MJ. Effect of subatmospheric pressure on the acute healing wound. Curr Surg. 2004;61:205–208
  28. Wackenfors A, Sjögren J, Gustafsson R, Algotsson L, Ingemansson R, Malmsjö M. Effects of vacuum-assisted closure therapy on inguinal wound edge microvascular blood flow. Wound Repair Regen. 2004;12:600–606

 This study was supported by the Åke Wiberg Foundation, the M. Bergvall Foundation, the Swedish Medical Association, the Royal Physiographic Society in Lund, the Swedish Medical Research Council, the Crafoord Foundation, the Swedish Heart–Lung Foundation, the Swedish Government Grant for Clinical Research, and the Swedish Hypertension Society.

PII: S0022-5223(07)01857-0

doi: 10.1016/j.jtcvs.2007.09.070

The Journal of Thoracic and Cardiovascular Surgery
Volume 135, Issue 5 , Pages 1007-1013 , May 2008