Self care at home for patients with vaccum assisted therapy after heart surgery
Ulrica Steingrimsson, Helene Eklund PeterssonAbstract
Introduction
Superficial postoperative wound infections after cardiac surgery contribute to prolonged hospitalisation, increased healthcare costs and reduced patient well-being. To support the national transition towards care closer to home, a home-based model for outpatient negative pressure wound therapy (VAC) was developed at Cardiothoracic centre at Sahlgrenska University hospital.
Methods
A multidisciplinary project group designed a pathway enabling home-based VAC therapy for patients with superficial sternal wound infections. Collaboration was established with the operating department for PICC-line insertion and with a community healthcare team to provide advanced nursing support in the home. Intravenous antibiotics were administered using elastomeric pumps to facilitate mobility and independence. Two nurse coordinators were appointed to deliver patient education and staff training. Routines for rounds, home blood sampling and VAC dressing changes were implemented. A four-month pilot period evaluated feasibility, safety, length of stay and patient-reported experience.
Results
Five patients received VAC therapy during the pilot period, of whom three were fully managed within the new model. For two of these patients, the mean hospital stay was 6.5 days. Patients feedback was consistently positive, highlighting increased autonomy, preserved daily routines and improved quality of life while undergoing treatment at home.
Discussion
Home-based VAC therapy for superficial postoperative wound infections after cardiac surgery was feasible, safe and well accepted by patients. The model, implemented as Thorax Hemma, strengthened person-centred care, clarified clinical responsibilities and enhanced competence in advanced home care. Potential to reduce bed occupancy and support a sustainable shift of appropriate care from hospital to home.