Negative pressure wound therapy versus conventional therapy for the treatment of post-coronary artery bypass graft mediastinitis

Mohamed Ahmed  Elgazzar; Ibrahim Reda   Kasab; Mohamed Mohamed  Saffan; Esraa Asaad Abdel-Maqsoud; Moataz EL-Shahaat  Rezk

Mohamed Ahmed Elgazzar Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Ibrahim Reda Kasab Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Mohamed Mohamed Saffan Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Esraa Asaad Abdel-Maqsoud Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt
Moataz EL-Shahaat Rezk Department of Cardiothoracic Surgery, Faculty of Medicine, Banha University, Banha, Egypt

Keywords: Mediastinitis, Negative pressure wound therapy, Conventional therapy

Abstract

Background: Various treatments, such as negative pressure wound therapy or traditional therapy, can be employed to manage postoperative mediastinitis. The superiority of one approach over the other is still a subject of discussion. Our purpose was to compare the results of negative pressure wound therapy and conventional therapy for treating postcoronary artery bypass graft mediastinitis.

Methods: This study included 50 individuals with mediastinitis after coronary artery bypass grafting. Patients were divided into Groups A and B according to whether the wound was treated with negative pressure wound therapy (n= 25) or conventional therapy (n= 25), respectively.

Results: The studied groups were comparable concerning age (P = 0.5), sex (P = 0.395), and body mass index (P = 0.556). No significant differences were detected among the studied groups concerning diabetes mellitus (P = 0.733), chronic obstructive pulmonary disease (P = 0.564), previous myocardial infarction (P = 0.370), isolated or combined surgery (P = 0.508), left main stenosis (P = 0.569), or emergency surgery (P = 0.508). Group A exhibited a significantly shorter hospital stay (26 ±4 days) than Group B (37 ±6) (P < 0.001). In contrast, no significant differences were observed among the studied groups concerning ventilation hours (P = 0.913) or ICU stay (P = 0.524). Group A demonstrated significantly lower reinfection than Group B (24% vs. 52%, respectively; P = 0.041). No significant differences were noted concerning reoperation for bleeding (P = 1.0) or mortality (P = 0.1). Group A demonstrated a significantly lower mean cost than Group B (110±23 vs. 140 ±37, respectively; P = <0.001).

Conclusion: Negative pressure wound therapy for postcoronary artery bypass graft mediastinitis could be more effective than the conventional treatment methods.