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Surgical site infection
Wound healing
Wound dressing

Modified application of vacuum-assisted closure in thoracic surgery patients

01 April 2022
Education

Abstract

Objective:

Surgical site infection (SSI), ranging from superficial, deep and to organ space, is one of the major predictors for morbidity and mortality in patients undergoing thoracic surgery. Care to accelerate SSI healing is taken to shorten hospital stay and reduce costs. The deep application of vacuum-assisted closure (VAC) in thoracic patients is not well established in the literature. In this study, the deep application and safety of VAC therapy in patients with various thoracic pathologies was evaluated.

Method:

A retrospective chart review of all patients who were admitted to the thoracic surgery service between July 2014 and July 2018 and who developed deep SSI was carried out.

Results:

A total of 12 patients were included, and their demographic data analysed. There were various thoracic pathologies complicated with postoperative deep SSI treated with VAC. The duration of VAC application ranged from 4–40 days with an average hospital stay of 37.6 days. All patients showed clinical, radiological and microbiological improvement rather than developing complications except for one case of mortality due to septicaemia.

Conclusion:

In this study, partial intrapleural VAC therapy was safe for use in patients who underwent thoracic surgery, regardless of the underling pathology, with caution (i.e., with continued monitoring of the patient's tolerance to the treatment). The overall hospital stay may be reduced with the use of VAC. It also decreased perioperative morbidity, secondary to wound infection.

Surgical site infection (SSI), ranging from superficial, deep and to the organ space, is one of the major predictors for morbidity and mortality in patients undergoing thoracic surgery. Care to accelerate SSI healing is taken to shorten the patient's hospital stay and to reduce costs. The application of vacuum-assisted closure (VAC) into the pleural space in thoracic patients is not well established in the literature.1 It is believed that VAC is a revolution in the management of SSI. It is a special form of local therapy that uses negative pressure.

In this study, the use and safety of a VAC device and its deep application in patients with various thoracic pathologies were examined, and our experience of introducing part of the VAC system into the pleural space described.

A retrospective chart review for all patients who were admitted under thoracic surgery in a university hospital in Saudi Arabia between July 2014 and July 2018, and who developed an SSI. Patients were excluded if they had a superficial SSI, were paediatric patients, patients in whom VAC was applied in the non-thoracic area (such as the abdomen) and patients who had prophylactic application of VAC (V.A.C GRANUFOAM SILVER dressings, 3M+KCI, US).

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intrapleural
negative pressure
pleural
SSI
surgical site infection
thoracic surgery
vacuum-assisted closure
VAC therapy
wound
wound care
wound dressing
wound healing