The doctoral dissertation in the field of Surgery will be examined at the Faculty of Health Sciences at the Kuopio campus.
What is the topic of your doctoral research?
We investigated if sternal wound infections after coronary artery bypass grafting (CABG) could be prevented with incisional negative pressure wound therapy (iNPWT). We also evaluated the role of negative pressure wound therapy (NPWT) in the treatment of deep sternal wound infections (DSWI) as well as the role of iNPWT after pectoralis major muscle flap reconstruction. In addition, we described two less commonly used flap reconstructions in the treatment of DSWI.
What are the key findings or observations of your doctoral research?
In contrast to previous studies, the use of iNPWT was not beneficial in the prevention of sternal wound infections after CABG. This is in contrast with previous studies. One explanation for the different results may be the small incidence of sternal wound infections in our hospital. Nonetheless, the use of iNPWT after pectoralis major muscle flap in the treatment of DSWI seemed beneficial. In the treatment of DSWI, NPWT was associated with increased mortality, a longer hospitalization length, a longer stay in the intensive care unit, and more visits to the operating room. Even after considering the confounding factors, these results raise a serious question about the safety and cost-efficiency of NPWT.
The two described flap reconstruction methods have been less frequently described in the treatment of DSWI. One of the methods has not been previously published. These methods were considered useful and may be used after individual decision making in the treatment of DSWI for suitable patients.
What were the key research methods and materials?
We analyzed four different study materials. The first material included a prospectively collected group of 180 high-risk patients who underwent CABG with postoperative iNPWT. A group of 772 high-risk patients served as historical controls. Other studies had retrospective design. NPWT was analyzed with a study group of 55 patients and 60 patients in the control group. The effect of iNPWT after pectoralis major muscle flap reconstruction was analyzed by comparing 24 patients in the study group with 48 patients in the control group. The flap reconstructions were demonstrated with patient series.
The doctoral dissertation of Heidi-Mari Myllykangas, Licentiate of Medicine, entitled Deep sternal wound infections - prevention and treatment will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Erkki Tukiainen of the University of Helsinki, and the Custos will be Docent Jari Halonen of the University of Eastern Finland. The public examination will be held in Finnish on 30 Oct 2021 and it will be streamed online.
