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Negative pressure wound therapy in patients with diabetes undergoing left internal thoracic artery harvest: A randomized control trial.
Jenkins, Sam; Komber, Mohamed; Mattam, Kavitha; Briffa, Norman.
Afiliación
  • Jenkins S; Department of Infection, Immunity, and Cardiovascular Disease, The University of Sheffield, Sheffield, United Kingdom.
  • Komber M; Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom.
  • Mattam K; Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom.
  • Briffa N; Department of Infection, Immunity, and Cardiovascular Disease, The University of Sheffield, Sheffield, United Kingdom; Department of Cardiothoracic Surgery, Sheffield Teaching Hospitals, NHS Foundation Trust, Sheffield, United Kingdom. Electronic address: n.briffa@sheffield.ac.uk.
J Thorac Cardiovasc Surg ; 167(1): 256-268, 2024 01.
Article en En | MEDLINE | ID: mdl-35550716
ABSTRACT

BACKGROUND:

Patients with diabetes undergoing CABG are at risk of wound infection. Incisional negative pressure wound therapy has been shown to be effective in decreasing incidence of infection in high-risk wounds. Near infrared spectroscopy (NIRS) can be used to assess wound oxygenation and low values can predict infection.

OBJECTIVES:

To evaluate utility of NIRS to assess wound oxygenation, to assess effect of sternotomy, left internal thoracic artery harvest, and wound dressing type on wound edge oxygenation.

METHODS:

In this blinded randomized control trial, patients with diabetes undergoing isolated coronary artery bypass grafting with a left internal thoracic artery were randomized to receive either incisional negative pressure wound therapy dressing or a standard dressing. NIRS measurements were made on the left upper arm (control), and left and right parasternal regions on day -1 (preoperative), day 5, and week 6 after surgery. Results were analyzed using repeated measures parametric methods.

RESULTS:

Eighty patients with diabetes were recruited, 40 to the incisional negative pressure wound therapy group and 40 to the standard dressing group. Adjusted NIRS readings dropped significantly in all patients by day 5 and partially recovered by week 6. In both groups, there was no difference between readings on the left and right. At all time points and on both sides, there was no difference in readings between patients in the 2 groups.

CONCLUSIONS:

NIRS can be used to assess oxygenation adjacent to a sternotomy wound. Adjusted tissue oxygen levels change with time after sternotomy and left internal thoracic artery harvest in patients with diabetes. Wound dressing type does not influence day 5 wound edge oxygenation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Terapia de Presión Negativa para Heridas / Arterias Mamarias Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Diabetes Mellitus / Terapia de Presión Negativa para Heridas / Arterias Mamarias Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Humans Idioma: En Revista: J Thorac Cardiovasc Surg Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Estados Unidos