{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T08:56:58Z","timestamp":1763629018362,"version":"3.45.0"},"reference-count":19,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"unspecified","delay-in-days":17,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"French public health services","award":["PHRC-N"],"award-info":[{"award-number":["PHRC-N"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,10,9]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cardiac surgical procedures are associated with a high incidence of postoperative infection, a risk attributed to their inherently invasive nature and extended duration. The goal of this study is to evaluate the efficacy of negative pressure wound therapy (NPWT) compared with standard dressings in preventing sternal scar dehiscence in patients undergoing cardiac surgery via complete vertical midline sternotomy, comparing a 3\u2009day change system (NPWT 3\/7 d) versus a 7\u2009day wear system (NPWT 7d) versus standard dressings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The PRISTER study is a prospective open-label multicentre, randomised, controlled, three-arm trial. Patients aged \u226518 years and meeting all the following inclusion criteria: patients undergoing scheduled or semiurgent cardiac surgery, with or without extracorporeal circulation, and patients managed by complete vertical median sternotomy will be recruited. Total sample size will consist of 660 patients. The primary outcome, surgical wound dehiscence after complete median sternotomy, expressed as occurrence or non-occurrence during the first 30 postoperative days, will be assessed by tablet calibrated photos analysed by an independent blinded staff. The secondary outcomes will be the number of dressing repairs between D7 (excluding initial protocol) and D90, length of initial hospital stay, occurrence of surgical site infection and its classification collected on day 90 (D90), use of an anti-infectious treatment and its duration, incidence of postoperative mediastinitis defined by dehiscence of the sternum with positive sternal samples, incidence of surgical revision for dehiscence of the surgical wound at D90 and collection of all operations involving surgical revision of the sternotomy wound, number of rehospitalisations (including hospital consultations) and their duration (evaluated at D90). Medicoeconomic assessment will be assessed by evaluation of hospital and extrahospital costs (number of days in hospital, consultations, rehospitalisations, imaging, biology and drugs), dressing costs and patient quality of life by EQ-5D-5L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study was approved by the French Agency for the Safety of Health Products (ANSM, Agence National de S\u00e9curit\u00e9 du M\u00e9dicament) as well as by the Ethics Committee (CPP Ile de France VIII) N\u00b0ID-RCB: 2023-A01782-43. Recruitment began in April 2024 and ended on 26 May 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      clinicaltrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT06207630\">NCT06207630<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104226","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T08:52:10Z","timestamp":1763628730000},"page":"e104226","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Reduction of the risk of complete sternotomy scar dehiscence in cardiac surgery: a protocol for a randomised, open-label multicentre clinical investigation comparing negative pressure wound therapy (NPWT) versus standard dressing (PRISTER study)"],"prefix":"10.1136","volume":"15","clinical-trial-number":[{"clinical-trial-number":"nct06207630","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct06207630","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Christophe","family":"Jayle","sequence":"first","affiliation":[{"name":"service de chirurgie thoracique et cardio-vasculaire, CHU Poitiers, Poitiers, France"},{"name":"INSERM, Centre d\u2019Investigation Clinique domaine d\u2019Innovation Technologique (CIC-IT) 1402, Universit\u00e9 de Poitiers, CHU de Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00e9raldine","family":"Allain","sequence":"additional","affiliation":[{"name":"service de chirurgie thoracique et cardio-vasculaire, CHU Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amandine","family":"Buono","sequence":"additional","affiliation":[{"name":"INSERM, Centre d\u2019Investigation Clinique domaine d\u2019Innovation Technologique (CIC-IT) 1402, Universit\u00e9 de Poitiers, CHU de Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Dang Van","sequence":"additional","affiliation":[{"name":"service de chirurgie cardiaque, Angers University Hospital, Angers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"D\u2019Ostrevy","sequence":"additional","affiliation":[{"name":"service de chirurgie Cardio-Vasculaire, CHU Clermont-Ferrand, Clermont-Ferrand, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"St\u00e9phane","family":"Kermen","sequence":"additional","affiliation":[{"name":"service de chirurgie cardiaque, CHU de Tours, Tours, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Picardo","sequence":"additional","affiliation":[{"name":"service de chirurgie thoracique et cardio-vasculaire, CHU Limoges, Limoges, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Pelras","sequence":"additional","affiliation":[{"name":"CHU Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Drux","sequence":"additional","affiliation":[{"name":"service de chirurgie thoracique et cardio-vasculaire, CHU Poitiers, Poitiers, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre","family":"Corbi","sequence":"additional","affiliation":[{"name":"service de chirurgie thoracique et cardio-vasculaire, CHU Poitiers, Poitiers, 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