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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Tremendous bleeding complication after vacuumassisted sternal closure. | Kiessling et al. Journal of Cardiothoracic Surgery 2011 6 16 http www.cardiothoracicsurgery.Org content 6 1 16 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Tremendous bleeding complication after vacuum-assisted sternal closure Arndt H Kiessling1 Andreas Lehmann3 Frank Isgro2 Anton Moritz1 Abstract Vacuum-assisted closure VAC of complex infected wounds has recently gained popularity among various surgical specialties. The system is based on the application of negative pressure by controlled suction to the wound surface. The effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation are proved. No contraindications for the use in deep sternal wounds in cardiac surgery are described. In our case report we illustrate a scenario were a patient developed severe bleeding from the ascending aorta by penetration of wire fragments in the vessel. We conclude that all free particles in the sternum have to be removed completely before negative pressure is used. Background Sternal wound healing disorders with an incidence of 1 to 5 are a frequent and serious complication following cardio-surgical operations 1 . Vacuum sealing treatment VST now represents an established procedure for the care of sternal infections 2 and is used by a majority of cardiac surgical centres in the Federal Republic of Germany for the management of deep post-sternotomy wounds 1 . Uniform treatment guidelines have not been published thus far. This also applies to contraindications for the use of vacuum sealing treatment in cardiac surgery. Until now the contraindications have been documented in general surgery and dermatology and focus on the direct effect of suction upon exposed blood vessels 3 . The following case report is intended to point out a possible contraindication from the field of cardiac surgery. Case presentation A 68 year old patient attended our outpatient department in October 2009 to undergo an elective coronary aortic .
