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Professor Malin Malmsjö, MD, PhD. Photo.

Malin Malmsjö

Professor

Professor Malin Malmsjö, MD, PhD. Photo.

Sternal stability at different negative pressures during vacuum-assisted closure therapy

Author

  • Arash Mokhtari
  • Rainer Petzina
  • Lotta Gustafsson
  • Johan Sjögren
  • Malin Malmsjö
  • Richard Ingemansson

Summary, in English

Background. Vacuum-assisted closure (VAC) is a widely used therapy in patients with poststernotomy mediastinitis. The aim of this study was to evaluate sternal stability during VAC application at seven negative pressures (-50 to -200 mm Hg) in a porcine wound model. Methods. Six pigs underwent median sternotomy and 2 steel wires were fixed at each sternal side and connected to a traction device. The device was connected to a force transducer linked to a force recorder. VAC therapy was applied to the wound. At each negative pressure, the length and width of the wound were measured before and after traction was started. Traction was increased stepwise up to 400 N. Results. The diastasis induced by a certain lateral force was similar in wounds treated with -75, -125, and -175 mm Hg. At -75 mm Hg, a significant improvement (p < 0.01) in sternal stability was seen compared with the open-chest setting. This was not further improved at -125 or -175 mm Hg. High negative pressures (-150 to -200 mm Hg) in combination with a high lateral force (> 200 N) increased the risk of separation of the foam from the wound edges, with air leakage or organ rupture as a result. Conclusions. Our results suggest that low negative pressures (-50 to -100 mm Hg) stabilize the sternum as efficiently as high negative pressures (-150 to -200 mm Hg). Low negative pressures (-50 to -100 mm Hg) were more beneficial, however, because no air leakage or organ rupture was observed at these pressures.

Department/s

  • Thoracic Surgery
  • Medicine/Emergency Medicine, Lund
  • Division of Microbiology, Immunology and Glycobiology - MIG

Publishing year

2006

Language

English

Pages

1063-1067

Publication/Series

Annals of Thoracic Surgery

Volume

82

Issue

3

Document type

Journal article

Publisher

Elsevier

Topic

  • Surgery
  • Cardiology and Cardiovascular Disease

Status

Published

ISBN/ISSN/Other

  • ISSN: 1552-6259