A Retrospective Study: RESULTS
Forty-two patients were evaluated between 1999 and 2002 for nonhealing sternal, spinal, and lower-extremity wounds. There were four patients on oral steroids, and none of the patients were on antigraft rejection drugs.
There were 12 patients with sternal wounds following coronary-artery-bypass grafting. The average age was 72 years. There were eight males and four females. All 12 patients had diabetes and coronary artery disease. Pathogens isolated included Staphylococcus (eight), Pseudomonas (two), mixed infection (one), and Candida (one). All 12 patients were treated with antimicrobials concomitantly with the wound care. No complications were observed. One patient had recurrence of the infection with the same pathogen and was retreated with success. The VAC was applied for an average of 12 days (range two-to-23 days). All 12 patients went onto complete wound closure by the end of four weeks.
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There were 14 patients in this group with an average age of 62 years. Eight of the patients, coronary artery disease, and peripheral vascular disease. Isolated pathogens included Staphylococcus (four), gram-negative pathogens (one), and anaerobes (one), and no cultures were obtained in eight patients. All 14 patients received antimicrobial therapy; one patient did not respond to therapy and had to undergo an above-knee amputation, while another underwent surgical closure. The wound VAC was applied with an average of 29.3 days, range of four-to-186 days.
There were 16 patients in this group with an average age of 59 years, five males, and 11 females. Eight of the patients had diabetes in addition to other predisposing conditions, such as rheumatoid arthritis and spinal stenosis. Infecting pathogens included Staphylococcus (15), Enterococcus (two), Candida (two), Pseudomonas aeruginosa (one), and a mixed infection (three). All 16 patients received antimicrobial therapy. One patient expired of unrelated causes. Recurrence of infections occurred in two patients who went onto successful healing once they were retreated. Eight patients went on to surgical closure, while the remaining eight patients went onto complete wound closure. Average length of VAC application was 27.6 days, (range two-to-178 days). The duration to wound closure was about eight weeks. canadian antibiotics