tailieunhanh - Báo cáo y học: " A rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: A rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy. | Lindstedt et al. Journal of Cardiothoracic Surgery 2011 6 90 http content 6 1 90 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access A rigid barrier between the heart and sternum protects the heart and lungs against rupture during negative pressure wound therapy Sandra Lindstedt Richard Ingemansson and Malin Malmsjo Abstract Objectives Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy NPWT in cardiac surgery. The use of a rigid barrier has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up and damaged by the sharp edges of the sternum. The aim of the present study was to investigate whether a rigid barrier protects the heart and lungs against injury during NPWT. Methods Sixteen pigs underwent median sternotomy followed by NPWT at -120 mmHg for 24 hours in the absence eight pigs or presence eight pigs of a rigid plastic disc between the heart and the sternal edges. The macroscopic appearance of the heart and lungs was inspected after 12 and 24 hours of NPWT. Results After 24 hours of NPWT at -120 mmHg the area of epicardial petechial bleeding was cm2 when no protective disc was used and cm2 when using the disc p . Heart rupture was observed in three of the eight animals treated with NPWT without the disc. Lung rupture was observed in two of the animals and lung contusion and emphysema were seen in all animals treated with NPWT without the rigid disc. No injury to the heart or lungs was observed in the group of animals treated with NPWT using the rigid disc. Conclusion Inserting a rigid barrier between the heart and the sternum edges offers protection against heart rupture and lung injury during NPWT. Introduction Cardiac surgery is complicated by poststernotomy mediastinitis in 1 to 5 of all procedures 1 and is a lifethreatening complication 2 . The reported early mortality .

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