الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Median sternotomy is the gold standard incision in open heart surgery. One of its most serious complications is sternal wound infection and dehiscence. The incidence of this complication was known to be about 0.15 -20%, although recent work shows that it is reduced to 2% but when this complication occurs , there are significant morbidity and mortality rates which exceed 20%.
There are different methods of classifying types of sternal wound infection and dehiscence but they are all about whether it is superficial infection affecting the skin and subcutaneous tissue or deep wound infection affecting the sternum and mediastinum.
We tried to compare two different regimens in management of sternotomy wound infection . We had two groups, Group A with the traditional method (open packing and daily dressing) and Group B with the vacuum assisted closure ( Negative pressure wound therapy).
In our study we found that the applications of vacuum assisted closure in complicated post sternotomy wounds has many advantages over the traditional method ( daily dressing with antiseptics) in many aspects such as the length of hospital stay, wound healing percent, amount of drainage and less rates of complications, morbidity and mortality.
Surgical treatment is mandatory in highly complicated cases with early aggressive debridement in all cases, and this goes before using any of the two methods that we compare here.
The vacuum assisted closure provides a variable and efficacious adjunctive method by method by which to treat postoperative wound infection after cardiac surgery. It is especially useful for managing sternal osteomyelitis in high risk patients and is an attractive option as a first line therapy followed by closure with wires or plates or combined with muscles and omental flaps
The postoperative care is an important issue not to be neglected , as these patients are usually high risk patients and have been debelited from these complications. It has an important role in preventing morbidity afterwards.