tailieunhanh - Báo cáo y học: "Sternum wound contraction and distension during negative pressure wound therapy when using a rigid disc to prevent heart and lung rupture"

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: Sternum wound contraction and distension during negative pressure wound therapy when using a rigid disc to prevent heart and lung rupture. | Lindstedt et al. Journal of Cardiothoracic Surgery 2011 6 42 http content 6 1 42 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Sternum wound contraction and distension during negative pressure wound therapy when using a rigid disc to prevent heart and lung rupture Sandra Lindstedt1 Richard Ingemansson1 and Malin Malmsjo2 Abstract Background There are increasing reports of deaths and serious complications associated with the use of negative pressure wound therapy NPWT of which right ventricular heart rupture is the most devastating. The use of a rigid barrier has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up against the sharp edges of the sternum. The aim of the present study was to determine whether a rigid barrier can be safely inserted over the heart with regard to the sternum wound edge movement. Methods Sternotomy wounds were created in eight pigs. The wounds were treated with NPWT at -40 -70 -120 and -170 mmHg in the presence and absence of a rigid barrier between the heart and the edges of the sternum. Wound contraction upon NPWT application and wound distension under mechanical traction to draw apart the edges of the sternotomy were evaluated. Results Wound contraction resulting from NPWT was similar with and without the rigid barrier. When mechanical traction was applied to a NPWT treated sternum wound the sternal edges were pulled apart. Wound distension upon traction was similar in the presence and absence of a the rigid barrier during NPWT. Conclusions A rigid barrier can safely be inserted between the heart and the edges of the sternum to protect the heart and lungs from rupture during NPWT. The sternum wound edge is stabilized equally well with as without the rigid barrier during NPWT. Introduction The use of negative pressure wound therapy NPWT for the treatment of deep sternal wound infections has been shown to have remarkable effects

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