Vacuum-assisted closure for postcardiac surgery mediastinitis in a patient on hemodialysis.

A 66-year-old man on hemodialysis underwent off-pump coronary artery bypass grafting. He was discharged in good condition on postoperative day (POD) 16. A high-grade fever and a purulent discharge emerged on POD 30. Methicillin-resistant Staphylococcus aureus was identified by culturing material from the wound. On admission, vacuum-assisted closure (VAC) therapy was applied for 80 days. Finally, good wound healing allowed us to perform simple wound closure without using muscle flaps or omentoplasty. VAC therapy is a useful and safe procedure for postcardiac surgery mediastinitis.