New strategy for treatment of MRSA mediastinitis: one-stage procedure for omental transposition and closed irrigation.
Mediastinitis due to methicillin-resistant Staphylococcus aureus is a devastating potential complication of cardiac surgery. We treated 4 patients with this condition using a new technique. First we performed an early radical removal of infected tissue and omental transposition with direct primary closure of the sternum and closed continuous irrigation with saline/vancomycin hydrochloride; that was followed by an administration of intravenous antibiotics. We obtained good clinical results, which are reported herein along with the clinical courses.
Hirata
Nobuaki
N
Division of Cardiovascular Surgery, Takarazuka Municipal Hospital, Takarazuka, Hyogo, Japan. hirata@xd5.so-net.ne.jp
Hatsuoka
Shinichi
S
Amemiya
Akira
A
Ueno
Takayoshi
T
Kosakai
Yoshio
Y
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003131:Combined Modality Therapy; D003646:Debridement; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D008482:Mediastinum / Q000601:surgery; D016106:Methicillin Resistance; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D012965:Sodium Chloride / Q000008:administration & dosage; D013203:Staphylococcal Infections / Q000209:etiology / Q000382:microbiology / Q000628:therapy*; D013211:Staphylococcus aureus / Q000187:drug effects; D013530:Surgical Wound Infection / Q000382:microbiology / Q000628:therapy*; D007507:Therapeutic Irrigation; D014640:Vancomycin / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D012965:Sodium Chloride; D014640:Vancomycin