Vacuum assisted closure therapy for the treatment of sternal wound infections in neonates and small infants

Link: Interactive CardioVascular and Thoracic Surgery

      Sternal wound infections occur with an incidence between 0.4% and 5% in the adult as well as the pediatric population. However, in contrast to the adults established treatment options do not exist in the pediatric population. We evaluated our preliminary results with 3 neonates respectively small infants (mean age 20.3�6 days) who underwent vacuum assisted closure (VAC) therapy for the treatment of sternal wound infections with the intention to enable secondary closure and preservation of the sternal bone. The mean VAC duration was 11.3 days, ranging from 10 to 12 days. After 3 dressing changes (every 48 to 72 h) the infection resolved and a secondary closure was feasible in all three patients. Isolated specimens were Candida albicans, Staphylococus aureus and MRSA respectively. These preliminary results, that VAC therapy is a promising alternative to the current treatment options available to neonates. Especially, the preservation of the sternal bone with enables normal thoracic cage stability and growth is a clear advantage over the currently used muscle flaps.