[Surgical treatment and adjunct hyperbaric therapy to improve healing of wound infection complications after sterno-mediastinitis].
Although the incidence of wound complications after median sternotomy is less than 1%, it remains a serious complication in patients undergoing cardiac procedures. We suggest that the combination of hyperbaric oxygen therapy and aggressive surgical approach improves clinical outcomes in these patients. Between August 1997 and May 2002, 55 patients with postoperative sternal wound infection and/or mediastinitis were qualified for hyperbaric oxygen treatment in connection to surgical management. Surgical procedure included wound debridment and/or sternum rewiring, omental pedicle flap plasty or sternectomy. Hyperbaric oxygen therapy consisted of 20 to 40 expositions per patient and was carried before and after the surgery.


RESULTS
There was no in-hospital death. The total time between the admission and discharge from the hospital varied from 2 to 24 weeks (average 8 weeks). The infection has been cured in all patients treated for postoperative sternal wound infection. That has been confirmed by negative bacteriological tests, stabilization of the sternum and complete wound healing.


CONCLUSIONS
The combination of surgical treatment and hyperbaric oxygen therapy may improve clinical outcome in patients with sterno-mediastinis and poststernotomy wound infection after cardiac surgery.
Siondalski
Piotr
P
Klinika Kardiochirurgii Instytutu Kardiologii Akademii Medycznej w Gdańsku. psiolo@amg.gda.pl
Keita
Luther
L
Sićko
Zdzisław
Z
Zelechowski
Paweł
P
Jaworski
Łukasz
Ł
Rogowski
Jan
J
D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003646:Debridement / Q000379:methods*; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D007902:Length of Stay; D008480:Mediastinitis / Q000209:etiology / Q000517:prevention & control*; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014945:Wound Healing
Leczenie chirurgiczne skojarzone z tlenoterapia hiperbaryczna powikłanego gojenia sie rany z zapaleniem śródpiersia i kości mostka.