The Use of Subcutaneous Hemovac Drain after Open Heart Surgery with Sternotomy
DOI:
https://doi.org/10.59958/hsf.7949Keywords:
Hemovac drain, median sternotomy, sternal wound complicationsAbstract
Background: This study investigated the effect of subcutaneous Hemovac drain use on sternal wound complications in patients with a body mass index (BMI) ≥30 kg/m2 undergoing open heart surgery through median sternotomy. Methods: This retrospective study included a total of 120 patients (74 males, 46 females) with a BMI ≥30 kg/m2 who underwent open heart surgery through median sternotomy between January 2021 and January 2024. The mean age was 60.36 ± 11.31 years (range, 18–80 y). After median sternotomy, a Hemovac drain was placed subcutaneously in the study group (n = 60) and in controls no Hemovac drain was placed (n = 60). Durations of hospital stay, types of surgery, sternal wound complications, and preoperative, intraoperative, and postoperative data were compared between the two groups. Results: The duration of hospital stay (p = 0.018; p < 0.05), the rate of sternal wound complications (p = 0.001; p < 0.01), the rate of superficial sternal complications (p = 0.001; p < 0.01), and the need for antibiotics in superficial infections (p = 0.001; p < 0.01) were significantly lower in cases with a Hemovac drain compared to those without. Conclusion: Subcutaneous placement of a Hemovac drain after open heart surgery is a simple, easily applicable, and effective method that reduces sternal wound complications, and hospital stay in obese patients.
References
Ulicny KS, Jr, Hiratzka LF. The risk factors of median sternotomy infection: a current review. Journal of Cardiac Surgery. 1991; 6: 338–351.
Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep sternal wound complications: incidence, risk factors and mortality. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2001; 20: 1168–1175.
Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surgery. 2017; 152: 784–791.
Salihi S, Kızıltan HT. Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery? Turk Gogus Kalp Damar Cerrahisi Dergisi. 2019; 27: 15–22.
Graf K, Ott E, Vonberg RP, Kuehn C, Haverich A, Chaberny IF. Economic aspects of deep sternal wound infections. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2010; 37: 893–896.
Sá MPBDO, Soares EF, Santos CA, Figueiredo OJ, Lima ROA, Escobar RR, et al. Risk factors for mediastinitis after coronary artery bypass grafting surgery. Revista Brasileira De Cirurgia Cardiovascular: Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular. 2011; 26: 27–35.
Molina JE, Lew RSL, Hyland KJ. Postoperative sternal dehiscence in obese patients: incidence and prevention. The Annals of Thoracic Surgery. 2004; 78: 912–912–7; discussion 912–7.
Risnes I, Abdelnoor M, Almdahl SM, Svennevig JL. Mediastinitis after coronary artery bypass grafting risk factors and long-term survival. The Annals of Thoracic Surgery. 2010; 89: 1502–1509.
Rashed A, Frenyo M, Gombocz K, Szabados S, Alotti N. Incisional negative pressure wound therapy in reconstructive surgery of poststernotomy mediastinitis. International Wound Journal. 2017; 14: 180–183.
Krishnamoorthy B, Al-Fagih OS, Madi MI, Najam O, Waterworth PD, Fildes JE, et al. Closed suction drainage improves clinical outcome in patients undergoing endoscopic vein harvesting for coronary artery bypass grafting. The Annals of Thoracic Surgery. 2012; 93: 1201–1205.
Tsujita E, Yamashita YI, Takeishi K, Matsuyama A, Tsutsui SI, Matsuda H, et al. Subcuticular absorbable suture with subcutaneous drainage system prevents incisional SSI after hepatectomy for hepatocellular carcinoma. World Journal of Surgery. 2012; 36: 1651–1656.
Fujii M, Bessho R, Miyagi Y, Nitta T. Negative-pressure sternal wound closure with interrupted subcuticular suturing and a subcutaneous drain tube reduces the incidence of poststernotomy wound infection after coronary artery bypass grafting surgery. Surgery Today. 2020; 50: 475–483.
Harish R, Kazi FN, Sharma JVP. Efficacy of Subcutaneous Closed Suction Drain in Reduction of Postoperative Surgical Site Infection. Surgery Journal (New York, N.Y.). 2021; 7: e275–e280.
Kaya E, Paksoy E, Ozturk E, Sigirli D, Bilgel H. Subcutaneous closed-suction drainage does not affect surgical site infection rate following elective abdominal operations: a prospective randomized clinical trial. Acta Chirurgica Belgica. 2010; 110: 457–462.
Ramsey PS, White AM, Guinn DA, Lu GC, Ramin SM, Davies JK, et al. Subcutaneous tissue reapproximation, alone or in combination with drain, in obese women undergoing cesarean delivery. Obstetrics and Gynecology. 2005; 105: 967–973.
Bjessmo S, Hylander S, Vedin J, Mohlkert D, Ivert T. Comparison of three different chest drainages after coronary artery bypass surgery–a randomised trial in 150 patients. European Journal of Cardio-thoracic Surgery: Official Journal of the European Association for Cardio-thoracic Surgery. 2007; 31: 372–375.
Published
How to Cite
Issue
Section
Copyright (c) 2024 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
