Renal failure was defined as a creatinine blood level of ≥120 µmol/l. Hypertension was defined as a systolic blood pressure of >140 mmHg. Patient characteristics, risk factors, procedure-related variables and treatment-related data were collected from both prospectively designed databases as individual medical records. Patients treated with closed drainage using Redon catheters ( n = 124) were included. A total of 252 patients developed mediastinitis (0.71%). Mediastinitis was determined according to the definition given by the Centers for Disease Control and Prevention (CDC). Antonius Hospital (Nieuwegein, Netherlands) and Amphia Hospital (Breda, Netherlands) the need for individual patient consent was waived.Ī total of 35 429 patients underwent cardiac operation via median sternotomy between 1 January 2000 and 1 January 2011 in these centres. The study was approved by the ethics committees of both St. In this large study, the results of two hospitals using closed drainage with high vacuum Redon drains for the treatment of post-sternotomy mediastinitis are presented and discussed. Currently, there are few studies with greater numbers of treated patients. Since the introduction of the method, five studies have shown Redon therapy to be feasible and safe. A primary closed sternum, less wound debridement and shorter length of treatment are the possible benefits of using this technique for the treatment of post-sternotomy mediastinitis. These drains were initially used in orthopaedic surgery, promoting adhesion of tissue layers, thereby minimizing haematoma formation and decreasing infection risks. introduced a closed drainage technique using high negative pressure with Redon drains. Serious adverse events during VAC therapy like right ventricular rupture have been reported, urging the need for alternative treatment modalities. This can be painful, leads to increased risk of super-infection and is relatively time-consuming and expensive. Additionally, VAC sponges have to be replaced twice a week. Patients have a prolonged period with an open sternum, which is an invalidating experience for them. Using VAC therapy, long-lasting in-hospital treatment is often required. VAC is associated with some important disadvantages. Nowadays, vacuum-assisted closure (VAC) is an established therapy for the treatment of post-sternotomy mediastinitis, resulting in decreased mortality and hospital stay. In the past decades, several treatment modalities have been described including wound treatment with open dressings, closed irrigation and omental and myocutaneous flap reconstruction. Post-sternotomy mediastinitis is a rare but devastating complication of cardiac surgery with prolonged hospitalization and mortality rates up to 25%.
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