Bilayered negative pressure wound therapy in prevention of lymphorrhagia in the patients with coronary artery bypass graft surgery: a randomized controlled trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

YUYongchao ¹ , SONGZhigang ¹ ,  XUZhiyun ¹ , BIHongda ² , LIJunhui ²

1. Department of Thoracic and Cardiovascular Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, P.R.China;
2. Department of Plastic Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, 200433, P.R.China;

Corresponding author：

XUZhiyun, Email: zhiyunx@hotmail.com

Keywords：

Bilayered negative pressure wound therapy; coronary artery bypass graft; great saphenous veins; lymphorrhagia

DOI：

10.7507/1007-4848.201605047

Video：

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Objective To investigate the function of a self-designed bilayered negative pressure wound therapy (b-NPWT) in reducing the occurrence of these complications through a clinical randomized controlled trial. Methods We included 72 coronary heart disease patients in our hospital from December 2013 through March 2014. There were 48 males and 24 females aged 38.4±18.6 years undergoing coronary artery bypass graft(CABG) surgery, and great saphenous veins were chosen as grafts. Patients were equally randomized into a trial group and a control group. The patients in the trial group underwent 5 d of b-NPWT for thigh incision and interrupted suture for shank incision after the harvesting of great saphenous veins. Patients in the control group received an interrupted suture for both thigh incision and shank incision after the harvesting of great saphenous veins. We evaluated the function of b-NPWT by reducing the complications arising from the harvesting of great saphenous veins in CABG patients. Results The incidences of early complications, such as lymphedema, incision infection, non-union, and skin flap necrosis of the vascular zone in the trial group were significantly lower than those of the control group. There was no death or new problem in heart or deep venous thrombosis in both groups. No complication occurred in long term. The incidence of lower limb edema was lower in the trial group than that in the control group at the end of 3 months follow-up. Conclusion B-NPWT can effectively prevent lymphorrhagia in CABG patients who underwent the harvesting of great saphenous veins. It can also reduce the incidence of complications and discomfort of the patients.

Citation： YUYongchao, SONGZhigang, XUZhiyun, BIHongda, LIJunhui. Bilayered negative pressure wound therapy in prevention of lymphorrhagia in the patients with coronary artery bypass graft surgery: a randomized controlled trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(2): 98-103. doi: 10.7507/1007-4848.201605047 Copy

1.	Kim KB, Lim C, Lee C, et al. Off pump coronary artery bypass may decrease the patency of saphenous vein grafts. Ann Thorac Surg, 2001, 72(3): 1033-1037.
2.	Kamiya H, Watanabe G, Takemura H, et al. Skeletonization of gastroep ip loicartery graft in off pump coronary artery bypass grafting: early clinical and angiogragphic assessment. Ann Thorac Surg, 2004, 77(6): 2046-50.
3.	Bi H, Fang S, Jiang D, et al. Ultrasound-guided scraping of fibrous capsule plus bilayered negative pressure wound therapy for treatment of refractory postmastectomy seroma. J Plast Reconstr Aesthet Surg, 2014, 11(20): 1748-1768.
4.	Zhou M, Yu A, Wu G, et al. Role of different negative pressure values in the process of infected wounds healing treated by vacuum-assisted closure: an experimental study. Int Wound J, 2012, 10(5): 508-515.
5.	Borgquist O, Ingemansson R, Malmsjö M. Wound edge microvascular blood flow during negative-pressure wound therapy: examining the effects of pressures from -10 to -175 mmHg. Plast Reconstr Surg, 2010, 125(2): 502-509.
6.	Bassetto F, Lancerotto L, Salmaso R, et al. Histological evolution of chronic wounds under negative pressure therapy. J Plast Reconstr Aesthet Surg, 2012, 65(1): 91-99.
7.	Borgquist O, Anesäter E, Hedström E, et al. Measurements of wound edge microvascular blood flow during negative pressure wound therapy using thermodiffusion and transcutaneous and invasive laser Doppler velocimetry. Wound Repair Regen, 2011, 19(6): 727-733.
8.	Kairinos N, Solomons M, Hudson DA. The paradox of negative pressure wound therapy--in vitro studies. J Plast Reconstr Aesthet Surg, 2010, 63(1): 174-179.
9.	Erba P, Ogawa R, Ackermann M, et al. Angiogenesis in wounds treated by microdeformational wound therapy. Ann Surg, 2011, 253(2): 402-409.
10.	Webster J, Scuffham P, Stankiewicz M, et al. Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. Cochrane Database Syst Rev, 2014, 10(7): 1458-1465.
11.	Labanaris AP, Polykandriotis E, Horch RE. The effect of vacuum-assisted closure on lymph vessels in chronic wounds. J Plast Reconstr Aesthet Surg, 2009, 62(8): 1068-1075.
12.	Thomson DR, Sadideen H, Furniss D. Wound drainage following groin dissection for malignant disease in adults. Cochrane Database Syst Rev, 2014, 11(11): 109-133.
13.	McMasters KM. Why does no one want to perform lymph node dissection anymore? Ann Surg Oncol, 2010, 17(2): 358-361.
14.	Satzger I, Meier A, Hoy L. Sentinel node dissection delays recurrence and prolongs melanoma-related survival: an analysis of 673 patients from a single center with long-term follow-up. Ann Surg Oncol, 2011, 18(2): 514-520.
15.	van Vledder MG, van der Hage JA, Kirkels WJ. Cervical lymph node dissection for metastatic testicular cancer. Ann Surg Oncol, 2010, 17(6): 1682-1687.
16.	Wagstaff MJ, Driver S, Coghlan P, et al. A randomized, controlled trial of negative pressure wound therapy of pressure ulcers via a novel polyurethane foam. Wound Repair Regen, 2014, 22(2): 205-211.
17.	毕宏达, 李军辉. 负压封闭引流治疗体表淋巴漏的初步观察. 中国美容整形外科杂志, 2010, 21(12): 731-733.

1. Kim KB, Lim C, Lee C, et al. Off pump coronary artery bypass may decrease the patency of saphenous vein grafts. Ann Thorac Surg, 2001, 72(3): 1033-1037.
2. Kamiya H, Watanabe G, Takemura H, et al. Skeletonization of gastroep ip loicartery graft in off pump coronary artery bypass grafting: early clinical and angiogragphic assessment. Ann Thorac Surg, 2004, 77(6): 2046-50.
3. Bi H, Fang S, Jiang D, et al. Ultrasound-guided scraping of fibrous capsule plus bilayered negative pressure wound therapy for treatment of refractory postmastectomy seroma. J Plast Reconstr Aesthet Surg, 2014, 11(20): 1748-1768.
4. Zhou M, Yu A, Wu G, et al. Role of different negative pressure values in the process of infected wounds healing treated by vacuum-assisted closure: an experimental study. Int Wound J, 2012, 10(5): 508-515.
5. Borgquist O, Ingemansson R, Malmsjö M. Wound edge microvascular blood flow during negative-pressure wound therapy: examining the effects of pressures from -10 to -175 mmHg. Plast Reconstr Surg, 2010, 125(2): 502-509.
6. Bassetto F, Lancerotto L, Salmaso R, et al. Histological evolution of chronic wounds under negative pressure therapy. J Plast Reconstr Aesthet Surg, 2012, 65(1): 91-99.
7. Borgquist O, Anesäter E, Hedström E, et al. Measurements of wound edge microvascular blood flow during negative pressure wound therapy using thermodiffusion and transcutaneous and invasive laser Doppler velocimetry. Wound Repair Regen, 2011, 19(6): 727-733.
8. Kairinos N, Solomons M, Hudson DA. The paradox of negative pressure wound therapy--in vitro studies. J Plast Reconstr Aesthet Surg, 2010, 63(1): 174-179.
9. Erba P, Ogawa R, Ackermann M, et al. Angiogenesis in wounds treated by microdeformational wound therapy. Ann Surg, 2011, 253(2): 402-409.
10. Webster J, Scuffham P, Stankiewicz M, et al. Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. Cochrane Database Syst Rev, 2014, 10(7): 1458-1465.
11. Labanaris AP, Polykandriotis E, Horch RE. The effect of vacuum-assisted closure on lymph vessels in chronic wounds. J Plast Reconstr Aesthet Surg, 2009, 62(8): 1068-1075.
12. Thomson DR, Sadideen H, Furniss D. Wound drainage following groin dissection for malignant disease in adults. Cochrane Database Syst Rev, 2014, 11(11): 109-133.
13. McMasters KM. Why does no one want to perform lymph node dissection anymore? Ann Surg Oncol, 2010, 17(2): 358-361.
14. Satzger I, Meier A, Hoy L. Sentinel node dissection delays recurrence and prolongs melanoma-related survival: an analysis of 673 patients from a single center with long-term follow-up. Ann Surg Oncol, 2011, 18(2): 514-520.
15. van Vledder MG, van der Hage JA, Kirkels WJ. Cervical lymph node dissection for metastatic testicular cancer. Ann Surg Oncol, 2010, 17(6): 1682-1687.
16. Wagstaff MJ, Driver S, Coghlan P, et al. A randomized, controlled trial of negative pressure wound therapy of pressure ulcers via a novel polyurethane foam. Wound Repair Regen, 2014, 22(2): 205-211.
17. 毕宏达, 李军辉. 负压封闭引流治疗体表淋巴漏的初步观察. 中国美容整形外科杂志, 2010, 21(12): 731-733.

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Bilayered negative pressure wound therapy in prevention of lymphorrhagia in the patients with coronary artery bypass graft surgery: a randomized controlled trial

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