Evidências para o tratamento tópico de deiscência de esternotomia mediana

Abstract

Introduction: Median sternotomy is a surgical technique that allows the access to intrathoracic organs. Associated complications occur in 0,5% to 8,4% of the reportedcases. These complications consist in infection and surgical wound dehiscence which can increase the hospital stay, patient morbidity/mortality, and also hospital costs. There is not a guideline in literature that standardizes the topical treatment of dehiscence after median sternotomy. This study is justified by the fact that theknowledgeof an effective topical treatment, associated with the best evidence could offer the patient a better rehabilitation. Objective: The objective is to identify in literature an effective topical treatment to median sternotomy wound dehiscence after cardiac surgery. Methodology: It is an integrative review based on two cohort studies, written in English that evaluate a group of patients with dehiscence of median sternotomy exposed to a conventional treatment and another group exposed to treatment with vacuum therapy. Results: In both studies there was a decrease in the occurrence of sepsis, local infection and costs in the group exposed to the vacuum therapy. However, there is still a lack of studies with a higher level of evidence to establish a guideline for the treatment of median sternotomy dehiscence. Conclusion: Vacuum therapy decreases infection and therefore is more effective than conventional treatment. It is expected that this review contributes for an evidence based nurse practice.