Background Incisional negative pressure wound therapy has been described as an effective method to prevent wound infections after open heart surgery in several publications. However, most studies have examined relatively small patient groups, only a few were randomized, and some have manufacturer-sponsorship. Most of the studies have utilized Prevena; there are only a few reports describing the PICO incisional negative pressure wound therapy system.

Methods We conducted a prospective cohort study involving a propensity score-matched analysis to evaluate the effect of PICO incisional negative pressure wound therapy after coronary artery bypass grafting. A total of 180 high-risk patients with obesity or diabetes were included in the study group. The control group included 772 high-risk patients operated before the initiation of the study protocol.

Results The rates of deep sternal wound infections in the PICO group and in the control group were 3.9 and 3.1%, respectively. The rates of superficial wound infections needing operative treatment were 3.1 and 0.8%, respectively. After propensity score matching with two groups of 174 patients, the incidence of both deep and superficial infections remained slightly elevated in the PICO group. None of the infections were due to technical difficulties or early interruption of the treatment.

Conclusion It seems that incisional negative pressure wound therapy with PICO is not effective in preventing wound infections after coronary artery bypass grafting. The main difference in this study compared with previous reports is the relatively low incidence of infections in our control group.

背景 切口负压伤口治疗已被描述为预防心脏直视手术后伤口感染的有效方法。然而，大多数研究都检查了相对较小的患者组，只有少数是随机的，有些有制造商赞助。大多数研究都使用了 Prevena；只有少数报道描述了 PICO 切口负压伤口治疗系统。

方法 我们进行了一项前瞻性队列研究，涉及倾向评分匹配分析，以评估冠状动脉旁路移植术后 PICO 切口负压伤口治疗的效果。研究组共纳入 180 名肥胖或糖尿病高危患者。对照组包括 772 名在研究方案开始前接受手术的高危患者。

结果 PICO组和对照组胸骨深部伤口感染率分别为3.9%和3.1%。需要手术治疗的浅表伤口感染率分别为3.1%和0.8%。在对两组 174 名患者进行倾向评分匹配后，PICO 组深部和浅部感染的发生率均略有升高。没有一个感染是由于技术困难或早期中断治疗造成的。

结论 PICO切口负压创面治疗似乎不能有效预防冠状动脉旁路移植术后创面感染。与之前的报告相比，本研究的主要区别在于我们对照组的感染发生率相对较低。