PMID: 9536503Apr 16, 1998Paper

Options for the management of poststernotomy mediastinitis

Scandinavian Cardiovascular Journal : SCJ
J SattaT Juvonen

Abstract

The management of 27 consecutive deep sternotomy wound infections is reviewed. In 22 cases the initial treatment was debridement, sternal refixation and dilute antibiotic irrigation via multiple irrigation-suction catheters. In the nine cases (41%) in which these measures failed, more extensive sternal and costal cartilage debridement and closure with a muscle flap were performed. Five cases were initially managed with major reconstructive surgery. For reconstruction, a bilateral pectoralis major myocutaneous flap was used alone in eight cases, while in six the flap was insufficient to obliterate the whole poststernectomy space, and was supplemented with rectus abdominis muscle. Early mediastinitis can be effectively treated with thorough wound debridement and mediastinal irrigation, but if there is a two-week delay from the initial sternotomy to manifestation of infection, radical debridement with muscle flap closure should be seriously considered.

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Citations

Jan 4, 2005·Respiration; International Review of Thoracic Diseases·Petey LaohaburanakitKen Yoneda
May 22, 2007·Journal of Cardiothoracic Surgery·Claudius DiezJochen Boergermann
Sep 26, 2008·Journal of Cardiothoracic Surgery·Cameron WangsgardLanny V Griffin
Mar 4, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Sharan KanakiriyaLuis A Juncos
Aug 26, 2006·Diagnostic Microbiology and Infectious Disease·Emilio BouzaAngel Pinto
May 17, 2002·The Journal of Hospital Infection·A TegnellL Ohman
Aug 16, 2005·The Heart Surgery Forum·Omer Faruk DoganEmre Acaroglu
Aug 5, 2003·Annals of Plastic Surgery·David T NetscherErnesto Soltero
Aug 29, 2018·The Thoracic and Cardiovascular Surgeon·Peter RothAndreas Böning

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