Treatment Outcomes of Postoperative Mediastinitis After Cardiac Surgery: A Comparison of Negative Pressure Wound Therapy Performed with Instillation Method and Non-Instillation Method

Abstract

Objective: Mediastinitis following cardiac surgery is potentially devastating complication. Various treatment modalities were suggested for this clinical situation and vacuum assisted closure is one of them. In the study it was aimed to compare outcomes of vacuum assisted closure performed with instillation and non-instillation methods. Materials and Methods: From January 2015 to June 2019, a total of 60 patients who had mediastinitis after cardiac surgery performed via sternotomy were included to the study. Both Group 1 and Group 2 was consisted of 30 patients to whom negative pressure wound therapy performed without and with instillation, respectively. Demographic characteristics and treatment outcomes were compared between the groups. Results: Demographic data of the patients were similar. Bacteriologic cultures showed the presence of staphylococci in the majority of the patients in both groups (Group 1, 61.6%; Group 2, 70%). Duration of treatment, eradication of the infection, wound closure and patients discharge were statistically lower in Group 2 (p<0.05). Rate of the patients with healed wound was statistically significantly higher in Group 2 (p<0.05). Conclusion: Vacuum assisted negative pressure therapy via instillation is a reliable method that can be performed in the treatment of mediastinitis and has superiority over non-instillation method.