Aim: Prospective assessment of patient population treated for sternal wound infection following cardiac surgery at our department. From November 2004 to September 2007, 40 consecutive patients who underwent vacuum-assisted closure therapy (VAC system; Hartmann-Rico) for a sternal wound infection were prospectively evaluated. Eleven patients (28 %) were managed for a superficial sternal wound infection and 29 (72 %) for a deep sternal wound infection. The identical therapeutic protocol was adop­ted for the entire group of patients.
Results: Thirty-eight patients were successfully healed (95 %). Two patients died (5 %), both from the group of patients with a deep sternal wound infection. The average length of in-hospital stay reached 40.6±20.8 days. The mean length of the VAC therapy was 12.6±5.4 days and the median VAC treatment time until surgical closure was 12.6±5.4 days. The VAC therapy was utilized solely as a bridge to definite wound closure. Four patients (10 %) with a chronic fistula were re-admitted with the range of 1 to 12 months after the VAC therapy.
Conclusions: The VAC therapy represents a safe and effective treatment strategy for sternal wound infections following car­diac surgery. The therapy is associated with a low failure rate and significant decrease in patients’ mortality. In case of deep sternal wound infection the VAC therapy should be considered as a first-line treatment option, particularly in the presence of wound hea­ling risk factors.

Key words: vacuum-assisted closure, sternal wound infection, cardiac surgery

The method of cleaning of varicose ulcers was first described by Hippokrates. The term “Debridement” was introduced by H. F. Le Dran approximately 2000 years later. The development of moist therapy falls into recent 30 years. The aim of modern debridement is to remove non-living tissue, to restore bacterial balance and to support wound healing. 
Four methods of debridement – autolytic, chemical, enzymatic and mechanical are available. 
Uncontrolled medical conditions, untreated coagulation disorders and irreversible impairment of blood vessels are general contraindications of debridement. Dressing of malignant defect is questionable.

Key words: debridement, methods of debridement, contraindications of debridement

A 75 years old patient was treated for ulcera cruris l. sin.; she had a history of recurrent thromboses and spontaneous abortion. Hematological assessment for suspected thrombophilia was recommended. Molecular genetic examination confirmed factor V Leiden mutation characterized by a replacement of glutamine by arginine. This mutation causes resistance to activated protein C. This resistance occurs in patients suffering from venous ulcers following thrombosis. In Europe Leiden mutation occurs in 3.5–12.5 %.

Key words: venous ulcers, recurrent thromboses, Leiden mutation

B.Braun Company announces the international competition aimed to explore and support innovative proposals, ideas or projects related to surgical wound healing.

Varicose ulcers prevalence data in Czech Republic were obtained using a method of representative selection survey. In the population >18 years there were 3.4 % of subjects who suffered from varicose ulcers in present or past. Two out of three cases are treated by GP; the use of ointments is the most frequent method of treatment. One third of cases are treated longer than one year and this number increases up to three thirds, if relatives suffer from this disease. 40 % of patients are not satisfied with the therapy.

Key words: varicose ulcers, prevalence of varicose ulcers

Wound healing proceeds in several phases – hemostasis, inflammation, proliferation and maturation. The whole process is controlled on both local and systemic level. 
Wound healing in diabetic patients is complicated by local changes of mediators (change of growing factors, extracellular matrix, enzymes), different cellular activity and granular tissue formation, bacterial or mycotic infections, higher prevalence of peripheral vascular disease and higher production of ROI (reactive oxygen intermediates). Healing is controlled by both already mentioned local factors and systemic factors, e.g. control of diabetes mellitus, capacity of immune system and nutritional status.

Key words: wound healing, diabetes mellitus, local and systemic factors of wound healing

Classification of health products in the chapter “Surgical dressing” helps physicians to cope with the Tariff book of VZP (General Health Insurance Company), because individual chapters correspond to therapeutical procedures. The law provides for the insurance companies to reimburse medical tools of size up to 10×10 cm and up to 150 Czech crowns per piece, based on the approval of the revisory physician. Amorphous devices represent an exception as approval by the revisory physician is not required and their compensation amounts 75 %.

Key words: tariff book of VZP, reimbursement by VZP, categorization of medical devices, surgical dressing, the Law No. 48/1997 Coll.

Film-coated graphic tool, which can be hanged directly bed-side, eliminates a difficultly available documentation of immobile patient. Attending staff can record, using a wipable marker, a position of the immobile patient and his/her balance of liquids every 2–3 hours. Easily available recording of current patient’s condition prevents complications, particularly development and progress of bedsores.

Key words: documentation of immobile patient, position of patient, balance of liquids, bedsores, prevention