Abstracts - 27 th EACTS

Objectives: Vacuum-assisted wound closure (VAC) is a well-established non-invasive active therapy to promote the healing of difficult wounds failing to heal with conventional treatment. We report our initial experience using this system in some cases of thoracic infections. Methods: From 2010, 21 patients, 13 males and eight women, mean age 68.2 (range 49-85) years, were treated with VAC therapy for thoracic infections. Twelve patients presented post-surgical sternal dehiscence and osteomyelitis, four a pleural empyema with minimal bronchial fistula (two postpneumonectomy, one post-bilobectomy) initially treated with thoracostomy, and five a necrotizing fasciitis of the chest wall. In 13 cases (eight sternal dehiscences and all necrotizing fasciitis), after debridement we chose a polyurethane sponge system; in the remaining eight cases (four sternal dehiscence and four pleural empyemas) we preferred medicated gauze. In all cases, 80 mmHg continuous negative pressure was applied with clinical control every 72 hours. Results: All patients had good results. In sternal dehiscences the mean time for infection control and tissue regeneration was four weeks. Eleven patients were surgically closed; one healed spontaneously. In pleural empyema and necrotizing fasciitis, VAC treatment resolved the infection and reduced the wound space in about three weeks. All patients affected by empyema underwent surgical treatment, as did one with necrotizing fasciitis; the remaining two healed spontaneously. Conclusions: Our experience shows that VAC therapy in cardiothoracic surgery seems to be an effective and safe alternative to conventional treatments for intrathoracic or deep wound infections. Its ease of use could benefit the comfort of the patient and reduce hospital stay. Interactive CardioVascular and Thoracic Surgery