Sternal stability at different negative pressures during vacuum-assisted closure therapy
A Mokhtari, R Petzina, L Gustafsson, J Sjögren… - The Annals of thoracic …, 2006 - Elsevier
A Mokhtari, R Petzina, L Gustafsson, J Sjögren, M Malmsjö, R Ingemansson
The Annals of thoracic surgery, 2006•ElsevierBACKGROUND: 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 …
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 …
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.
Elsevier
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