Volume 30, Issue 2 pp. 190-193
Perioperative Management

Vacuum-Assisted Closure System in Newborns After Cardiac Surgery

Sergio Filippelli M.D.

Sergio Filippelli M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

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Gianluigi Perri M.D.

Corresponding Author

Gianluigi Perri M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

Address for correspondence: Gianluigi Perri, M.D., Department of Pediatric Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, 00165 Roma, Italy. Fax: +39-06-68592670; e-mail: [email protected]Search for more papers by this author
Gianluca Brancaccio M.D.

Gianluca Brancaccio M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

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Francesca G. Iodice M.D.

Francesca G. Iodice M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

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Sonia B. Albanese M.D.

Sonia B. Albanese M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

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Eugenio Trimarchi

Eugenio Trimarchi

Pediatric Cardiac Surgery Unit, San Vincenzo Hospital, Taormina, Italy

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Adriano Carotti M.D.

Adriano Carotti M.D.

Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy

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First published: 03 November 2014
Citations: 7
Conflict of interest: The authors acknowledge no conflict of interest in the submission.

Abstract

Objective

To analyze the effectiveness and the results of the use of a vacuum-assisted closure (VAC) system for the treatment of complex sternal wounds in newborns after cardiac surgery.

Methods

From May 2008 until December 2012, six patients developed post-sternotomy wound problems (large defects of epithelialization or mediastinitis), which were treated with a VAC system. Median age at the time of institution of VAC was 24.5 days (range 16 to 65 days). Median time of treatment was 14 days (range 3 to 42 days).

Results

All patients were newborns and all underwent delayed sternal closure after cardiac surgery. The indications for using the VAC system were: mediastinitis in two patients (33.3%) and impairment of healing without signs of infection in four (66.7%). All children after VAC therapy achieved healing of the sternal wound. VAC therapy was started with high negative pressures (−125 mmHg) continuously then switched to an intermittent modality in all patients.

Conclusion

VAC system with high negative pressure is safe, effective, and is a well-tolerated therapy in newborns with complex sternal wounds. doi: 10.1111/jocs.12463 (J Card Surg 2015;30:190–193)

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