الفهرس 
Anatomy of the SternumOnly 14 pages are availabe for public view
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Abstract
The VAC (vacuum-assisted closure) system is a noninvasive active therapy to promote healing in difficult wounds that fail to respond to established treatment modalities. The system is based on the application of negative pressure by controlled suction to the wound surface. The method was introduced into clinical practice in 1996. Since then, numerous studies proved the effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation.
Since the introduction of median sternotomy by Julian in 1956, sternal wound infections have been a notable and potentially life-threatening complication after open heart surgery, with a reported incidence between 1% and 5%. Despite improvements in antibiotic treatment and techniques of wound care, a 10% to 20% mortality rate as well as substantial morbidity remained constant over the time
During the last decades the main treatment was based on intravenous antibiotic therapy and several surgical techniques, with an increase in hospital stay and mortality.
More recently, the vacuum-assisted closure (VAC) technique has been introduced for the treatment of these complex wounds, obtaining a faster wound healing, a lower length of hospital stay with a subsequent lower in-hospital cost, reducing also the long-term mortality rate.