Management of deep bed sore with closed irrigation in cardiac surgery: Experience with the use of normal saline solution

Abstract

Bed sore after cardiac surgery is a serious complication with high morbidity and mortality rates. We performed normal saline closed irrigation as an alternative to open aggressive debridement and muscle flap operations. A total of 38 patients with bed sore after cardiac surgery were studied 22 patients were in class 1 and 2 were excluded from this study and 16 patients with class 3 deep seated bed sore underwent this study with closed normal saline irrigation solution. Most of the bed sores with infections were associated with several predisposing risk factors such as: advanced age, disorders of skin integrity, organ system failure and cardiac cachexia in the preoperative state. One of these pafients died of adult respiratory distress syndrome in ihe postoperative course, one patient died of pneumonia and sepsis but the remaining 14 patients were discharged with their wounds well healed. Acute and deep bed sore infection occurred in these patients from the fifth day after cardiac surgery up to 14 days after the operation. The infection was successfully treated with gross necrotic material debridement and continuous closed irrigation with normal saline. We conclude that early debridement of bed sore and continuous closed wound irrigation with normal saline are effective in the management of deep seated bed sore after cardiac surgery. é Medwell Journals, 2009.