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Post-operative deep sternal wound infection (DSWI) is a quite uncommon complication in cardiac surgery with
high mortality and morbidity rates. Since vacuum-assisted closure (VAC) has shown promising results, we assessed its impact on
the management of DSWI in terms of the assessment of contributing risk factors.
Retrospective study of 52 consecutive patients who have been treated with VAC for DSWI out of a total of 83 patients
with DSWI (out of 7234 cardiac operations) in a single institution (study period: September 2003- March 2012). Statistical
analysis (Kaplan-Meier survival analysis, correlation and multiple regression) of the patient data was undertaken in assessing the
contribution of the risk factors to the outcome of patients.
Of the 52 patients (35 M: 17 F), 88.5% (n=46) were solely treated with VAC therapy and 11.5% (n=6) had additional
plastic surgical intervention. Follow-up was complete (mean: 33.8 months) with an overall mortality rate of 26.9% (n=14) of
whom 50% (n=7) died in hospital. No death was related to VAC complications. Patient outcomes were affected by pre-operative,
intra-operative and post-operative risk factors. The two risk factors showing the greatest correlation on the survival of the patients
were the logistic EuroSCORE and the post-operative hospital stay (r=-0.25, p<=0.05 and r=-0.21, p>=0.05 respectively).
Logistic EuroSCORE, post-operative hospital stay, advanced age, chronic obstructive pulmonary disease (COPD)
and long-term corticosteroid treatment appear to be significant contributing factors on the long-term survival of patients treated
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