2026 Volume 55 Issue 2 Pages 41-46
[Objective] The incidence of surgical site infection (SSI) following open heart surgery has been documented to range from 1-10%. A particular concern is deep sternal wound infection (DSWI), which is a serious complication associated with a high mortality rate, significant reduction in patient quality of life, and increased medical costs due to prolonged hospitalization. Various methods have been reported to prevent SSI, and closed incision negative pressure therapy (ciNPT) for closed surgical wounds has been covered by insurance in Japan since April 2021 to prevent SSI in high-risk cases. In our hospital, ciNPT was introduced in July 2021 and has been actively used in patients for whom it is indicated. The aim of this study was to evaluate the effectiveness of ciNPT in preventing SSI after open heart surgery in patients at high risk of SSI. [Methods] In the course of open heart surgery with median sternotomy carried out between 2020 and 2022, 306 patients deemed to be at high risk of SSI were included in the study. The term “high-risk patients" was defined as individuals suffering from one of the following conditions: severe obesity (BMI ≥ 30), diabetes mellitus with HbA1c ≥ 7.0%, bilateral internal thoracic artery harvest, chronic maintenance dialysis, oral steroids, oral immunosuppressive drugs, prolonged surgery (duration>8 h), revision surgery, skin disease that may interfere with wound healing, or active infectious disease. Patients were divided into a ciNPT group (161 cases) using ciNPT and a control group (145 cases) using standard dressings. A statistical study of SSIs within 30 days of surgery was performed. [Results] The total SSI (ciNPT group: 5 cases vs. control group: 12 cases; p=0.04) demonstrated a significant decrease. Although no significant differences were observed in superficial SSI (ciNPT group: 3 cases vs. control group: 4 cases; p=0.71) and DSWI (ciNPT group: 2 cases vs. control group: 8 cases; p=0.05), a decreasing trend was observed. Multivariate analysis showed that ciNPT was a preventive factor for SSI, reducing the incidence of SSI by 73.2% (odds ratio 0.268; 95% confidence interval 0.081~0.891).[Conclusion] It is suggested that ciNPT in patients at high risk of SSI may reduce SSI.
