Vacuum-Assisted Closure with a Portable System in the Treatment of Sternum Dehiscence after Cardiac Surgery

(Department of Cardiovascular Surgery, Ibaraki Seinan Medical Center Hospital, Ibaraki, Japan)

Kanji Matsuzaki Hideya Unno
A 62-year-old man with ischemic heart disease suffered from a poststernotomy wound trouble after coronary artery bypass grafting. We performed vacuum-assisted closure (VAC), minimally invasive treatment for difficult wounds, because he had severe heart failure and depressive disorder. This therapy assists in wound healing by applying localized negative pressure to the surface of the wound, and its effectiveness for poststernotomy mediastinitis has already been reported in several countries. It is, however, very difficult for us to obtain a manufactured device, the V.A.C.® system (KCI, San Antonio, Texas), which is not available in Japan yet. Therefore, we had to make a self-made system which combined RetractorPad® polyvinyl alcohol hydrofoam (Mondomed NV, Harmont, Belgium) and J-VAC® closed wound drainage system (Johnson&Johnson, Tokyo, Japan). This self-made system, without a vacuum pump machine, was small and light enough to be carried by the patient even in the early postoperative period. In this case, VAC resulted in complete healing of the wound in about 3 weeks with little pain, stress, effort and time, and with reasonable cost in comparison to conventional treatment. This is a useful and hopeful option in the treatment of not only sternum dehiscence but also mediastinitis after cardiac surgery, especially for high-risk patients.
@Jpn. J. Cardiovasc. Surg. 34: 225-228 (2005)