Guidelines for treatment of complex chest wounds with negative pressure wound therapy

Complex chest wounds from trauma, infection, tumor, and post-surgical complications provide challenges to surgeons because of the vital structures within the thorax. Median sternotomy is the most common cause of complex chest wounds. An expert panel of cardiac and plastic surgeons reviewed the medical literature on complex chest wounds using an evidence-based approach. Negative pressure wound therapy (NPWT) is an increasingly common modality to treat complex chest wounds. Evidence to date demonstrates that NPWT is a safe and effective modality for treating complex chest wounds. Reports indicate that NPWT removes wound exudates, stimulates granulation tissue formation, and reduces the number of dressing changes. In general, NPWT is used as a bridge to surgical closure but is occasionally used as a primary wound treatment. Further studies are needed to better understand the mechanism of action, optimize utilization protocols, and demonstrate the cost effectiveness of this new technology.