The role of negative pressure wound therapy with instillation and dwell time in the treatment of deep sternal wound infections-A retrospective cohort study

Background and AimsNegative pressure wound therapy (NPWT) has gained a central role in the treatment of deep sternal wound infections (DSWIs) after median thoracotomy. Our study aims at proving the safety of using NPWT with instillation and dwell time (NPWTi-d) in the treatment of DSWI. MethodsWe retrospectively evaluated the patients who were treated at our institution between March 2018 and November 2021 for DSWI after radical sternectomy using NPWT or NPWTi-d. The NPWTi-d was applied to start the first postoperative day using 75 mmHg negative pressure for 3 h, followed by instillation of sodium hypochlorite The NPWTi-d group showed a shorter length of stay (29.39 & PLUSMN; 12.09 vs. 39.54 & PLUSMN; 17.07 days; p = 0.049), a shorter elapsed time between the debridement and the flap coverage (7.18 & PLUSMN; 4.27 vs. 11.86 & PLUSMN; 7.7 days; p = 0.003) and less operative or nonoperative dressing changes (1.73 & PLUSMN; 1.14 vs. 2.68 & PLUSMN; 56; p < 0.001). The in-hospital mortality was 8.2%, with no significant differences between the two groups (p = 1). ConclusionNPWTi-d can be safely employed in the treatment of DSWI. Further prospective randomized studies need to establish the role of NPWTi-d in the control of infection and biofilm as well as in wound healing.