The cost of vacuum-assisted closure therapy in treatment of deep sternal wound infection

被引:42
作者
Mokhtari, Arash [1 ]
Sjogren, Johan [1 ]
Nilsson, Johan [1 ]
Gustafsson, Ronny [1 ]
Malmsjo, Malin [2 ]
Ingemansson, Richard [1 ]
机构
[1] Univ Lund Hosp, Dept Cardiothorac Surg, S-22185 Lund, Sweden
[2] Univ Lund Hosp, Dept Internal Med, S-22185 Lund, Sweden
关键词
health economics; health policy; mediastinitis; wound closure; CABG; sternum;
D O I
10.1080/14017430701744469
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. Surgical sites infections are very expensive and the total costs for coronary artery bypass grafting (CABG) surgery followed by deep sternal wound infection (DSWI) with conventional therapy are estimated to be 2.8 times that for normal, CABG surgery. Promising results have been reported with vacuum-assisted closure (VAC) therapy in patients with DSWI. This study presents the cost of VAC therapy in patients with DSWI after CABG surgery. Design. Thirty-eight CABG patients with DSWI, between 2001 and 2005, were treated with VAC therapy. The cost of surgery, intensive care, ward care, laboratory tests and other costs were analyzed. Results. No three-month mortality or recurrent infection was observed. The average cost of CABG procedure and treatment of DSWI was 2.5 times higher than the mean cost of CABG alone. No significant correlations were found between the preoperative EuroSCORE and the cost of DSWI therapy. Conclusions. VAC therapy for patients who underwent CABG surgery followed by DSWI seems to be cost effective, and has low mortality rate.
引用
收藏
页码:85 / 89
页数:5
相关论文
共 21 条
[1]   Evaluation of vacuum-assisted closure in the treatment of poststernotomy mediastinitis [J].
Domkowski, PW ;
Smith, ML ;
Gonyon, DL ;
Drye, C ;
Wooten, MK ;
Levin, LS ;
Wolfe, WG .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2003, 126 (02) :386-390
[2]   SUPPURATIVE MEDIASTINITIS AFTER OPEN-HEART-SURGERY - A CASE-CONTROL STUDY COVERING A 7-YEAR PERIOD IN SANTANDER, SPAIN [J].
FARINAS, MC ;
PERALTA, FG ;
BERNAL, JM ;
RABASA, JM ;
REVUELTA, JM ;
GONZALEZMACIAS, J .
CLINICAL INFECTIOUS DISEASES, 1995, 20 (02) :272-279
[3]   The vacuum-assisted closure system for the treatment of deep sternal wound infections after cardiac surgery [J].
Fleck, TM ;
Fleck, M ;
Moidl, R ;
Czerny, M ;
Koller, R ;
Giovanoli, P ;
Hiesmayer, MJ ;
Zimpfer, D ;
Wolner, E ;
Grabenwoger, M .
ANNALS OF THORACIC SURGERY, 2002, 74 (05) :1596-1600
[4]   Postoperative mediastinitis in cardiac surgery -: microbiology and pathogenesis [J].
Gårdlund, B ;
Bitkover, CY ;
Vaage, J .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2002, 21 (05) :825-830
[5]   CDC DEFINITIONS FOR NOSOCOMIAL INFECTIONS, 1988 [J].
GARNER, JS ;
JARVIS, WR ;
EMORI, TG ;
HORAN, TC ;
HUGHES, JM .
AMERICAN JOURNAL OF INFECTION CONTROL, 1988, 16 (03) :128-140
[6]   Deep sternal wound infection:: A sternal-sparing technique with vacuum-assisted closure therapy [J].
Gustafsson, RI ;
Sjögren, J ;
Ingemansson, R .
ANNALS OF THORACIC SURGERY, 2003, 76 (06) :2048-2053
[7]   The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery [J].
Hollenbeak, CS ;
Murphy, DM ;
Koenig, S ;
Woodward, RS ;
Dunagan, WC ;
Fraser, VJ .
CHEST, 2000, 118 (02) :397-402
[8]   MANAGEMENT OF DEEP STERNAL WOUND-INFECTION AFTER CARDIAC-SURGERY - HANUMAN SYNDROME [J].
IVERT, T ;
LINDBLOM, D ;
SAHNI, J ;
ELDH, J .
SCANDINAVIAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1991, 25 (02) :111-117
[9]   STERNAL WOUND COMPLICATIONS AFTER ISOLATED CORONARY-ARTERY BYPASS-GRAFTING - EARLY AND LATE MORTALITY, MORBIDITY, AND COST OF CARE [J].
LOOP, FD ;
LYTLE, BW ;
COSGROVE, DM ;
MAHFOOD, S ;
MCHENRY, MC ;
GOORMASTIC, M ;
STEWART, RW ;
GOLDING, LAR ;
TAYLOR, PC .
ANNALS OF THORACIC SURGERY, 1990, 49 (02) :179-187
[10]   Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery [J].
Lu, JCY ;
Grayson, AD ;
Jha, P ;
Srinivasan, AK ;
Fabri, BM .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2003, 23 (06) :943-949