[Experience with pyoktanin lavage for mediastinitis and prosthetic graft infection following thoracic aortic surgery].
Pyoktanin, a triphenylmethane dye, is known to have a potent bactericidal activity against Gram-positive bacteria including methicillin-resistant Staphylococcus aureus (MRSA). We used pyoktanin for irrigating wounds in 2 cases of mediastinitis and prosthetic graft infection following thoracic aortic surgery. Case 1 is mediastinitis and prosthetic graft infection due to Staphylococcus epidermidis following Cabrol procedure. After irrigating the anterior mediastinum with 0.1% pyoktanin solution twice a day for 8 days, omental transposition was performed, which let to cure of the infection. Case 2 is mediastinitis due to methicillin-resistant Staphylococcus epidermidis following ascending aortic and aortic arch replacement for acute type A aortic dissection. After irrigating the wound with 0.1% pyoktanin solution twice a day for 14 days, the wound was closed primarily, which resulted in cure of the infection of the wound. Using pyoktanin at low concentrations for irrigating wound for a short period of time is considered permissible and effective for mediastinitis and prosthetic graft infection due to Gram-positive bacteria including MRSA.
Higashi
S
S
Department of Cardiovascular Surgery, Shizuoka Red Cross Hospital, Shizuoka, Japan.
Miyamoto
T
T
Hashizume
K
K
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005840:Gentian Violet / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000628:therapy*; D016106:Methicillin Resistance; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy*; D016459:Prosthesis-Related Infections / Q000628:therapy*; D013203:Staphylococcal Infections / Q000628:therapy*; D013211:Staphylococcus aureus / Q000187:drug effects; D007507:Therapeutic Irrigation / Q000379:methods
D000891:Anti-Infective Agents, Local; D005840:Gentian Violet