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Vacuum-assisted closure therapy for the management of deep sternal wound complications: A systematic review and meta-analysis.
Christodoulou, Neophytos; Wolfe, Brandon; Mathes, David W; Malgor, Rafael D; Kaoutzanis, Christodoulos.
Afiliación
  • Christodoulou N; Royal Papworth Hospital, Papworth Rd, Trumpington, Cambridge, UK.
  • Wolfe B; School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States.
  • Mathes DW; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States.
  • Malgor RD; Division of Vascular Surgery and Endovascular Therapy, University of Colorado, Anschutz Medical Center, Aurora, Colorado, United States.
  • Kaoutzanis C; Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States. Electronic address: ckaoutzanis@gmail.com.
J Plast Reconstr Aesthet Surg ; 2023 Oct 17.
Article en En | MEDLINE | ID: mdl-37951723
BACKGROUND: Vacuum-assisted closure (VAC) therapy has become a popular treatment option for wound healing. The aim of this meta-analysis was to assess the use of VAC therapy as a bridge before the definitive treatment for the management of deep sternal wound complications. METHODS: A systematic literature review and meta-analysis were performed in PubMed and Embase. Outcomes of interest included mortality, treatment failure, length of hospital stay (LOS), length of intensive care unit (ICU) stay and cost of treatment. RESULTS: Twenty-two studies involving 1980 patients were included in the quantitative synthesis of this meta-analysis. Patients treated with VAC had significantly lower overall mortality [1738 patients; Risk ratio [RR] = 0.36 (95% confidence interval [CI]: 0.25, 0.51)], treatment failure [1210 patients; RR = 0.26 (95% CI: 0.19, 0.37)], LOS [498 patients; (standard mean difference = -0.44 (95% CI: -0.81, -0.07)] and ICU stay [309 patients; (standard mean difference = -0.34 (95% CI: -0.67, -0.01)] compared to that of non-VAC patients. VAC therapy was associated with reduced cost of treatment per patient compared with that of non-VAC therapies (reductions of 3600 USD, 6000 USD and 8983 USD in the reported studies). CONCLUSIONS: VAC therapy as an adjunct in the definitive treatment of patients with deep sternal wound complications was associated with lower mortality, treatment failure, LOS, ICU stay and cost of treatment when compared with a non-VAC approach. Randomised controlled trials would be essential to confirm these findings.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Systematic_reviews Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Systematic_reviews Idioma: En Revista: J Plast Reconstr Aesthet Surg Año: 2023 Tipo del documento: Article Pais de publicación: Países Bajos