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Vacuum assisted closure therapy for the treatment of sternal wound infections in neonates and small infants

^a Department of Cardiothoracic Surgery, Leitstelle 20A, AKH Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
^b Department of Pediatrics, PICU, Medical University of Vienna, AKH Vienna, 1090 Vienna, Austria

*Corresponding author. Tel.: +43-1-404005620; fax: +43-1-404005640.

E-mail address: tatjana.fleck{at}meduniwien.ac.at (T. Fleck).

Sternal wound infections occur with an incidence between 0.4 and 5% in the adult as well as the pediatric population. However, in contrast to the adults, established treatment options do not exist in the pediatric population. We evaluated our preliminary results with 3 neonates, respectively, small infants (mean age 20.3±6 days) who underwent vacuum assisted closure (VAC) therapy for the treatment of sternal wound infections with the intention to enable secondary closure and preservation of the sternal bone. The mean VAC duration was 11.3 days, ranging from 10 to 12 days. After three dressing changes (every 48 to 72 h) the infection resolved and a secondary closure was feasible in all three patients. Isolated specimens were Candida albicans, Staphylococcus aureus and MRSA, respectively. These preliminary results show that VAC therapy is a promising alternative to the current treatment options available to neonates. Especially, the preservation of the sternal bone which enables normal thoracic cage stability and growth, is a clear advantage over the currently used muscle flaps.

Key Words: Sternal wound infection; Vacuum assisted closure; Small infant; Cardiac congenital surgery

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