A Survey of Cardiac Surgery Infections With PICO Negative Pressure Therapy in High-Risk Patients

Ann Thorac Surg. 2020 Dec;110(6):2034-2040. doi: 10.1016/j.athoracsur.2020.03.087. Epub 2020 May 1.

Abstract

Background: Surgical site complications represent major concerns in many surgical specialties and lead to an increased length of hospital stay and the need for additional treatments and care. This investigation aimed to report survey data from the introduction of the PICO negative pressure wound therapy system (Smith & Nephew, Hull, United Kingdom) in a single hospital in France regarding cardiac surgical procedures through standard median sternotomy.

Methods: The patients in this study were at high risk of developing surgical site infections. PICO was used immediately postoperatively on the closed incision sites in all patients undergoing cardiac surgical procedures. Data were compared with a retrospective cohort of patients in whom PICO had not been used postoperatively. In total, 233 anonymized patient records were reviewed, 142 of which used the PICO device and 91 of which did not.

Results: PICO was shown to provide both clinical and economic benefits over standard care across a range of different cardiac surgical patients. The rates of complications, including deep surgical wound infections and mediastinitis, were reduced.

Conclusions: As noted, PICO had advantages over standard care in these patients, and complication rates decreased. This study demonstrated cost savings and an increase in available surgical and hospital capacity related to PICO use.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures / adverse effects*
  • Female
  • France
  • Humans
  • Male
  • Middle Aged
  • Negative-Pressure Wound Therapy*
  • Retrospective Studies
  • Risk Factors
  • Sternotomy / adverse effects*
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Surveys and Questionnaires