Using of Vacuum Assisted Closure System in Treatment of Post Sternotomy Mediastinitis Systematic Review and Meta-Analysis

Abstract Background: The median sternotomy incision was first described for use in cardiac surgery by Julian and colleagues in 1957. They demonstrated discrete advantages of the median sternotomy incision for cardiac surgery, particularly, improved surgical efficiency, excellent exposure of the heart, great vessels and pulmonary hila, and reduced pulmonary trauma. This was a convincing argument for median sternotomy as the incision of choice for cardiac surgical procedures. Aim of Study: The present study was the evaluation of the efficacy and safety of using of vacuum assisted closure system in treatment of post sternotomy mediastinitis. Material and Methods: A search of the scientific literature was carried out querying electronic databases to identify relevant studies about VAC therapy and post sternotomy mediastinitis: PubMed, Embase, Cochrane Library, Dare, Sumsearch and Scirus. Results: Application of inclusion and exclusion criteria to study abstracts yielded 8 articles. A total of 400 studies were identified from the database search. After review, a total of 11 studies were selected. This systematic review and meta-analysis conducted among 11 studies and aimed at evaluation for the efficacy and safety of VAC in treatment of sternal wound infection. Conclusion: This meta-analysis concluded that VAC when used in treatment of DSWI, can lower mortality and ICU admission days. Diabetes and obesity were common among those who had deep sternal wound infection.