RF62 PREVENTION OF STERNAL WOUND INFECTION WITH PREVENA DRESSING

Abstract

Background: Sternal wound infections are a common complications in cardiac surgery. Our aim is to investigate if negative pressure on close wound with Prevenatm dressing might be a good method of prevention in selected high risk patients. Methods: We retrospectively reviewed 1115 consecutive patients that had cardiac surgery operation at Oxford University Hospital from January 2017 to May 2018. A single surgeon used Prevena dressing as prevention for wound infections in a group of high risk patients. The dressing was applied in theatre at -125mmHg and removed prior to discharge. The choice of the patient was led by surgeon decision with a Fowler score greater than 10. Results: 25 patients received Prevena dressing, 15 of them underwent CABG. Only one developed superficial wound infection, but his Fowler score was 26 (predicted infection 16%). In our department sternal wound infection for heart operations was 2.4% (3.9% in CABG group). The average Fowler score in Prevena group was 16.8 and 18 in CABG sub-group with a predicted wound infection respectively of 6.6% and 8.2%. The wound infection rate on Prevena was 0% in the non-CABG group and 6.6% in CABG group. The cost of Prevena is 330£, while the cost per day of a patient with wound infection can be as high as 2000£ Conclusion: Close incision negative pressure therapy with Prevena dressing is a cost effective and safe tool in selective high risk patient that can help reducing the incidence of sternal wound infection in selected high risk cardiac surgical patient.