{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T03:59:11Z","timestamp":1769831951511,"version":"3.49.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Pediatric sternal wound complications (SWCs) include sterile wound dehiscence (SWD) and superficial\/deep sternal wound infections (SSWI\/DSWI), and are generally managed by repetitive debridement and surgical wound approximation. Here, we report a novel nonsurgical management strategy of pediatric sternotomy wound complications, using serial noninvasive wound approximation technique combined with single-use negative pressure wound therapy (PICO) device.<\/jats:p><jats:p>\n          Methods\u2003Nine children with SWCs were managed by serial approximation with adhesive skin tapes and serial PICO device application. Thorough surgical debridement or surgical approximations were not performed.<\/jats:p><jats:p>\n          Results\u2003Three patients were clinically diagnosed as SWD, two patients as SSWI, and four patients as DSWI. None of the wounds demonstrated apparent mediastinitis or bone destructions. PICO device was applied at 16.1 days (range: 6\u201326 days) postoperatively, together with serial wound approximation by skin tapes. The average duration of PICO use was 16.9 days (range: 11\u201329 days) and the wound approximation was achieved in all patients. None of the patients underwent aggressive surgical debridement or invasive surgical approximation by sutures.<\/jats:p><jats:p>\n          Conclusion\u2003We report our successful management of selected pediatric SWCs, using serial noninvasive wound approximation technique combined with PICO device.<\/jats:p>","DOI":"10.1055\/s-0040-1722733","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T01:06:43Z","timestamp":1612487203000},"page":"056-064","source":"Crossref","is-referenced-by-count":4,"title":["Treatment of Pediatric Sternotomy Wound Complications: A Minimally Invasive Approach"],"prefix":"10.1055","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8671-6429","authenticated-orcid":false,"given":"Taehee","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun Key","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jss.2015.07.045","article-title":"Risk factors of infected sternal wounds versus sterile wound dehiscence","volume":"200","author":"R H Fu","year":"2016","journal-title":"J Surg Res"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1053\/j.jvca.2019.09.019","article-title":"Deep sternal wound infection: diagnosis, treatment and prevention","volume":"34","author":"P HY Phoon","year":"2020","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/1471-2334-7-112","article-title":"Superficial and deep sternal wound infection after more than 9000 coronary artery bypass graft (CABG): incidence, risk factors and mortality","volume":"7","author":"A Salehi Omran","year":"2007","journal-title":"BMC Infect Dis"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1097\/00000637-199706000-00002","article-title":"Vacuum-assisted closure: a new method for wound control and treatment: clinical experience","volume":"38","author":"L C Argenta","year":"1997","journal-title":"Ann Plast Surg"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1097\/01.prs.0000178401.52143.32","article-title":"Vacuum-assisted closure for sternal wounds: a first-line therapeutic management approach","volume":"116","author":"J P Agarwal","year":"2005","journal-title":"Plast Reconstr Surg"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1016\/j.jtcvs.2018.10.152","article-title":"Advances in managing the noninfected open chest after cardiac surgery: negative-pressure wound therapy","volume":"157","author":"F G Bakaeen","year":"2019","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.bjps.2007.05.004","article-title":"Vacuum-assisted closure in the treatment of poststernotomy mediastinitis in the paediatric patient","volume":"61","author":"B Salazard","year":"2008","journal-title":"J Plast Reconstr Aesthet Surg"},{"issue":"01","key":"ref8","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1055\/s-0037-1603933","article-title":"Vacuum-assisted closure therapy for the treatment of poststernotomy wound dehiscence in neonates and infants","volume":"67","author":"M A Padalino","year":"2019","journal-title":"Thorac Cardiovasc Surg"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"e33","DOI":"10.1308\/003588412X13171221499261","article-title":"Topical negative pressure for the treatment of neonatal post-sternotomy wound dehiscence","volume":"94","author":"J Hardwicke","year":"2012","journal-title":"Ann R Coll Surg Engl"},{"issue":"06","key":"ref10","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.ejcts.2006.09.020","article-title":"Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm","volume":"30","author":"J Sj\u00f6gren","year":"2006","journal-title":"Eur J Cardiothorac Surg"},{"issue":"06","key":"ref11","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S1010-7940(02)00562-6","article-title":"Vacuum-assisted closure in the paediatric patient with post-cardiotomy mediastinitis","volume":"22","author":"I R Ramnarine","year":"2002","journal-title":"Eur J Cardiothorac Surg"},{"issue":"02","key":"ref12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/PCC.0000000000002131","article-title":"Vacuum-assisted closure for the treatment of deep sternal wound infection after pediatric cardiac surgery","volume":"21","author":"G Sherman","year":"2020","journal-title":"Pediatr Crit Care Med"},{"issue":"01","key":"ref13","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1093\/icvts\/ivu050","article-title":"Negative pressure therapy for post-sternotomy wound infections in young children","volume":"19","author":"H Kawajiri","year":"2014","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"ref14","first-page":"e20","article-title":"Application of the single use negative pressure wound therapy device (PICO) on a heterogeneous group of surgical and traumatic wounds","volume":"14","author":"C Payne","year":"2014","journal-title":"Eplasty"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/iwj.12080","article-title":"Simplified negative pressure wound therapy: clinical evaluation of an ultraportable, no-canister system","volume":"12","author":"D A Hudson","year":"2015","journal-title":"Int Wound J"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1097\/WON.0000000000000407","article-title":"Treatment of dehisced, thoracic neonatal wounds with single-use negative pressure wound therapy device and medical-grade honey: a retrospective case series","volume":"45","author":"V Boyar","year":"2018","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"10","key":"ref17","doi-asserted-by":"crossref","first-page":"289","DOI":"10.25270\/WNDS\/2017.10.289296","article-title":"Traction-assisted internal negative pressure wound therapy with bridging retention sutures to facilitate staged closure of high-risk wounds under tension","volume":"29","author":"M V DeFazio","year":"2017","journal-title":"Wounds"}],"container-title":["The Thoracic and Cardiovascular 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