eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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3/2016
vol. 13
 
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abstract:

Hyperbaric oxygen therapy as additional treatment in deep sternal wound infections – a single center’s experience

Radosław Litwinowicz
,
Magdalena Bryndza
,
Anna Chrapusta
,
Ewa Kobielska
,
Bogusław Kapelak
,
Grzegorz Grudzień

Kardiochirurgia i Torakochirurgia Polska 2016; 13 (3): 198-202
Online publish date: 2016/09/30
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Introduction: Deep sternal wound infection (DSWI) is one of the most serious complications after cardiac surgery procedures, observed in 5% of patients. Current standard medical therapy for DSWI includes antibiotics, surgical debridement, resuturing or negative pressure wound therapy (NPWT). Unfortunately, in some cases these methods are insufficient, and additional therapeutic options are needed.

Aim: To assess the effects and usefulness of additional hyperbaric oxygen therapy (HBO2) in patients with DSWI after cardiac surgery procedures.

Material and methods: A retrospective analysis of 10 patients after cardiac surgery who developed DSWI in the period 2010–2012 was performed. After 3 months of ineffective conventional therapy including targeted antibiotic, surgical sternal debridement and NPWT, patients were qualified for additional HBO2 therapy. A total of 20 sessions of HBO2 therapy were performed, each 92 minutes long.

Results: After 4 weeks of HBO2 treatment, 7 patients presented complete wound healing with fibrous scar formation. One patient was qualified for the another cycle of HBO2 therapy with 20 additional sessions, and complete wound healing was observed. In 2 cases, after 5 and 19 sessions, HBO2 was interrupted because of improper qualifications.

Conclusions: The HBO2 as an additional therapy in DSWI was successful in 80% of cases, and no complications were observed. However, due to the small number of published studies with a small number of patients, randomized, clinical trials are needed to assess the clinical results of HBO2 in DSWI after cardiac surgery procedures.
keywords:

hyperbaric oxygen therapy, deep sternal wound infection

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