Negative Pressure Wound Therapy in Patients with Diabetes Undergoing Left Internal Thoracic Artery Harvest: A Randomized Control Trial.

Background: Patients with diabetes undergoing CABG are at risk of wound tion. Incisional negative pressure wound therapy has been shown to be effective decreasing incidence of infection in high-risk wounds. Near infrared spectroscopy (NIRS) can be used to assess wound oxygenation and low values can infection. Objectives: To evaluate utility of NIRS to assess wound oxygenation, to fect of sternotomy, left internal thoracic artery harvest, and wound dressing wound edge oxygenation. Methods: In this blinded randomized control trial, patients with diabetes ing isolated coronary artery bypass grafting with a left internal thoracic artery randomized to receive either incisional negative pressure wound therapy or a standard dressing. NIRS measurements were made on the left upper trol), and left and right parasternal regions on day -1 (preoperative), day 5, after surgery. Results were analyzed using repeated measures parametric methods. Results: Eighty patients with diabetes were recruited, 40 to the incisional pressure wound therapy group and 40 to the standard dressing group. NIRS readings dropped significantly in all patients by day 5 and partially by week 6. In both groups, there was no difference between readings on the right. At all time points and on both sides, there was no difference in readings tween patients in the 2 groups. Conclusions: NIRS can be used to assess oxygenation adjacent to a sternotomy wound. Adjusted tissue oxygen levels change with time after sternotomy internal thoracic artery harvest in patients with diabetes. Wound dressing does not influence day 5 wound edge oxygenation. (J Thorac Cardiovasc 2024;167:256-68)