[Continuous irrigation followed by combined omental transposition and pectral muscle rotation for treatment of postoperative mediastinitis with DIC in a child].
A 8-year-old boy was complicated with mediastinitis with DIC 20 days after replacement of the stenotic right ventricular outflow conduit. Open drainage and débridement were performed and semi-closed continuous irrigation with 1% povidone iodine was continued for 10 days to control DIC. Thereafter, the pedicled omentum was mobilized to the upper anterior mediastinum, however, it was too thin to obliterate there. To obliterate the upper anterior mediastinum and cover the infected graft, the major pectoral muscle flap was introduced to the anterior mediastinum through the window created by removing a part of left second rib. The sternum was closed primarily. The postoperative course has been well and no recurrence has been proved for 1 year.
Department of Thoracic and Cardiovascular Surgery, Tohoku University School of Medicine, Sendai, Japan.
M
M
Ohmi
K
K
Sato
H
H
Yokoyama
M
M
Miura
K
K
Haneda
H
H
Mohri
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D004211:Disseminated Intravascular Coagulation / Q000150:complications*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery*; D009852:Omentum / Q000637:transplantation*; D011183:Postoperative Complications / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*; D007507:Therapeutic Irrigation