小児開心術後縦隔炎に対する非侵襲的閉創デバイスを併用した持続陰圧吸引療法の2例

Traction-assisted Negative Pressure Wound Therapy for Pediatric Poststernotomy Mediastinitis：Report of Two Cases

はじめに　Zip Surgical Skin Closure（Zip­Line Medical社，Campbell：以下，Zip）は真皮縫合を代用する新しい創閉鎖用デバイスである．ストラップロック方式で創を両端から引き寄せるため，体内に異物を残さず，皮膚の瘢痕化抑制効果などが期待されている．われわれは小児開心術後縦隔炎に対して，陰圧閉鎖療法（NPWT）にZipを併用することで，固定性の向上と創の引き寄せ効果による創閉鎖の促進が得られ，組織の補塡や再縫合を行わずに創閉鎖が可能であった症例を経験したので報告する．

We herein report two cases of pediatric poststernotomy mediastinitis treated by traction-assisted negative pressure wound therapy （NPWT） with Zip Surgical Skin Closure （Zip）, which is a non-invasive skin closure device. We used this device with NPWT in cases of pediatric poststernotomy mediastinitis to stabilize the sternum and reduce the natural retractive forces of the skin. The patients were two boys （two and three months old）, with an onset of infection at 13 and eight postoperative days, respectively. The culture examination detected methicillin-susceptible Staphylococcus aureus in both cases. Traction-assisted NPWT with Zip was performed at－75 mmHg for 16 and 33 days, and the wounds healed completely. In conclusion, this modification was successfully applied to treat pediatric poststernotomy mediastinitis and may help reduce the duration of treatment.