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2 Cases of Mediastinitis After Median Sternotomy Surgery Treated with Vacuum‐Assisted Closure

Introduction: Mediastinitis, which is at times encountered after thoracic surgery with median sternotomy, is often resistant for treatments and in cases leads to death. We applied vacuum‐assisted closure (V.A.C.) for 2 cases of post‐sternotomy mediastinitis, in an original manner using readily available materials and made them healed. The details are reported. Methods: We applied polyurethane foam (HydroSite®, Smith & Nephew) with silicone tube (BLAKE®, ETHICON) on the debrided wound, covered it with surgical draping film (Ioban® 2, 3M Health Care), and applied continuous negative pressure with a wall suction. The dressing was changed at intervals of 2 to 3 days. Results:(Case 1) A 53‐years old male with complications of diabetes mellitus and hypertension underwent coronal artery bypass graft surgery for angina pectoris. Sternal infection occurred in postoperative period and the wound was opened. (Case 2) A 78‐years old male underwent total aortic arch replacement surgery for aortic dissection. The wound was opened for a postoperative infection. We applied vacuum‐assisted closure therapy for these 2 cases in the method presented above and observed promoted wound granulation and rapid contraction of wounds, with no manifestations of increasing infection or changes of circular conditions. Each of the cases was healed with vacuum‐assisted closure in 7 Weeks without any surgical procedures. Conclusions: We viewed vacuum‐assisted closure therapy as another choice of the treatment for mediastinitis.