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Science, Practice and Education
Although the popularity of TNP in cardiac surgery is
growing, only few studies comparing TNP with conventional
treatment have been conducted (22, 23). However,
superiority of TNP has been proved in terms of reduction
of primary therapy failure and in-hospital mortality. Moreover,
the first available data of long-term analysis showed
reduction of the long-term mortality; a better quality of
life in comparison with the conventional therapy (24).
Presented comparative studies showed that the conventional
therapy of DSWI is associated with an unacceptable
high risk of failure. Additionally, those patients who had
required further surgery because of the primary therapy
failure had also been at considerably high risk of prolonged
ICU-, in-hospital stay, and particularly an increased risk of
in-hospital mortality. TNP requires multiple surgical procedures
including debridement and foam dressing changes,
however, the overall length of the therapy as well as the
hospital stay is shown to be comparable with the conventional
therapy if the additional therapy for the primary
failure has been included. The risk to right ventricle or
grafts injury was comparably rare in both techniques, but
nevertheless, represented a fatal consequence of DSWI.
The TNP group showed a statistically significant decrease
in primary therapy failure (p