| Vacuum-Assisted Closure with a Portable System
in the Treatment of Sternum Dehiscence after Cardiac Surgery |
(Department of Cardiovascular Surgery,
Ibaraki Seinan Medical Center Hospital, Ibaraki, Japan)
| Kanji Matsuzaki |
Hideya Unno |
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A 62-year-old man with ischemic
heart disease suffered from a poststernotomy wound trouble
after coronary artery bypass grafting. We performed vacuum-assisted
closure (VAC), minimally invasive treatment for difficult wounds,
because he had severe heart failure and depressive disorder.
This therapy assists in wound healing by applying localized
negative pressure to the surface of the wound, and its effectiveness
for poststernotomy mediastinitis has already been reported in
several countries. It is, however, very difficult for us to
obtain a manufactured device, the V.A.C.® system (KCI, San
Antonio, Texas), which is not available in Japan yet. Therefore,
we had to make a self-made system which combined RetractorPad®
polyvinyl alcohol hydrofoam (Mondomed NV, Harmont, Belgium) and
J-VAC® closed wound drainage system (Johnson&Johnson, Tokyo, Japan).
This self-made system, without a vacuum pump machine, was small
and light enough to be carried by the patient even in the early
postoperative period. In this case, VAC resulted in complete
healing of the wound in about 3 weeks with little pain, stress,
effort and time, and with reasonable cost in comparison to
conventional treatment. This is a useful and hopeful option in
the treatment of not only sternum dehiscence but also mediastinitis
after cardiac surgery, especially for high-risk patients.
Jpn. J. Cardiovasc. Surg. 34: 225-228 (2005) |
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