e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Comparison of treatment approaches for mediastinitis after coronary artery bypass grafting: Negative pressure wound therapy versus conventional methods
Hasan Toz1, Yusuf Kuserli1, Gülsüm Türkyılmaz1, Ali Aycan Kavala1, Saygın Türkyılmaz1
1Department of Cardiovascular Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2025.28035
Background: This study aims to compare the effectiveness of negative-pressure wound therapy (NPWT) compared to conventional methods for the treatment of mediastinitis following coronary artery bypass grafting.

Methods: Between January 2010 and January 2023, a total of 87 patients (47 males, 40 females; mean age: 62.0±10.2 years; range, 35 to 80 years) who developed mediastinitis following sternotomy were retrospectively analyzed. The patients were divided into two groups: those treated with conventional methods (n=39) from January 2010 to February 2015 and those treated with NPWT (n=48) from March 2015 to January 2023. Clinical outcomes, including treatment duration, infection resolution time, hospital stay, and mortality rate, were recorded.

Results: The NPWT group had significantly shorter treatment durations (20.1±4.0 days) than the conventional group (58.6±17.1 days, p<0.001). The time to achieve negative cultures was also significantly reduced in the NPWT group (15.3±3.6 days) compared to the conventional group (36.7±8.1 days, p<0.001). The length of hospital stay was shorter in the NPWT group (34.3±12.8 days) compared to the conventional group (88.0±21.1 days, p<0.001). The NPWT group had a lower hospital mortality rate (4.2%) than the conventional group (17.9%, p=0.049).

Conclusion: The NPWT demonstrated superior efficacy in managing postoperative mediastinitis compared to conventional methods, highlighting its potential as a preferred treatment option for this serious complication.

Keywords : Coronary artery bypass grafting, mediastinitis, negativepressure wound therapy, postoperative complications, wound healing
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