小児心臓外科手術後の手術部位感染に対する局所陰圧閉鎖療法

DOI 参考文献26件
  • 金谷 知潤
    大阪府立母子保健総合医療センター心臓血管外科
  • 川田 博昭
    大阪府立母子保健総合医療センター心臓血管外科
  • 盤井 成光
    大阪府立母子保健総合医療センター心臓血管外科
  • 小澤 秀登
    大阪府立母子保健総合医療センター心臓血管外科
  • 山内 早苗
    大阪府立母子保健総合医療センター心臓血管外科
  • 岸本 英文
    大阪府立母子保健総合医療センター心臓血管外科

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タイトル別名
  • Negative Pressure Wound Therapy for Surgical Site Infection after Pediatric Cardiac Surgery

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Background: Although negative pressure wound therapy (NPWT) is widely used as a therapy for surgical site infection (SSI), few reports have discussed NPWT after pediatric cardiac surgery.<BR>Objective: To evaluate the efficacy of NPWT for 7 pediatric patients with SSI (superficial infections 4, mediastinitis 3) after cardiac surgery between January 2010 and January 2011.<BR>Methods: Seven patients were treated with NPWT for uncontrollable pus discharges even with focal irrigation. Pressure of NPWT, periods of NPWT, microorganisms, recurrence, resuture, and complications associated with NPWT were determined. Polyurethane foam was used as the dressing foam. A drain with a side hole was made. Polyurethane foam and the drain were sealed with a film dressing. The pressure was set at -200 to -300 mmHg.<BR>Results: Median duration of NPWT was 28 days (range, 14-106 days) and methicillin-resistant Staphylococcus aureus was the causative microorganism in all 7 patients. Two cases were recurrent. Two cases underwent resuture for wound dehiscence. No complications associated with NPWT, deep mediastinitis, uncontrollable sepsis, or systemic infectious disease were encountered.<BR>Summary: Seven cases were treated with NPWT for SSI after pediatric cardiac surgery. Although there were problems about the setup of optimal pressure of NPWT, or the treatment for SSI of high risk patients, NPWT could be one of the choices of treatment for SSI or mediastinitis.

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