Abstract
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.