A simple management of mediastinitis.
Between January 1, 1986 and December 31, 1993, 6940 open heart procedures were performed via median sternotomy at Hacettepe University Medical Center. Mediastinitis developed in 55 patients (0.79%). Twenty-four were children. All were reoperated for treatment of mediastinitis. Following radical debridment 17 were irrigated with dilute povidone-iodine solution after primary reclosure (Group A), the remaining 38 were simply reclosed while leaving just drains in the mediastinum (Group B). Hospital mortality was 17.65% in Group A and 15.79% in Group B. Time of hospitalization after treatment in living patients was 17.6 days in Group A and 16.3 days in Group B. A mortality of 15.79% is an acceptable result which shows early radical debridment and drainage of the mediastinum is the most important cornerstone of the treatment of mediastinitis and is mostly enough with proper systemic antibiotic therapy.
Pasaoglu
I
I
Thorax and Cardiovascular Surgery Department Hacettepe University, Ankara, Turkey.
Arsan
S
S
Yorgancioglu
A C
AC
Yüksel Bozer
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D011206:Povidone-Iodine / Q000627:therapeutic use; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery*; D007507:Therapeutic Irrigation
D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine