Should an infected Nuss bar be removed?
BACKGROUND
The Nuss procedure is a minimally invasive procedure for correction of pectus excavatum. It involves insertion of a substernal metal bar. A feared complication of any implanted device is infection, which often necessitates removal. The purpose of this report is to describe the authors' experience with infectious complications after the Nuss procedure.


METHODS
From February 2000 to July 2002, 102 patients underwent the Nuss procedure in 2 pediatric surgical centers. In a retrospective way, the files of those patients in whom a postoperative infection developed were studied.


RESULTS
Seven patients suffered postoperative infectious complications. Only one bar needed to be removed.


CONCLUSIONS
The authors' experience indicates that there is no need for immediate removal of an infected Nuss bar. Most of these infections can be managed conservatively. However, early antibiotic treatment is warranted to ensure salvage of the bar.
Van Renterghem
Katrien M
KM
Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center, PO Box 85090, 3508AB Utrecht, The Netherlands.
von Bismarck
Silvester
S
Bax
Nikolaas M A
NM
Fleer
Andre
A
Höllwarth
Michael E
ME
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D005660:Funnel Chest / Q000601:surgery*; D006801:Humans; D007239:Infections / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D019919:Prosthesis Implantation; D016459:Prosthesis-Related Infections / Q000188:drug therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents