title: Should an infected Nuss bar be removed?
abstract: 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.
authors.affiliation: Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center, PO Box 85090, 3508AB Utrecht, The Netherlands.
authors.forename: Katrien M
authors.initials: KM
authors.lastname: Van Renterghem
authors.forename: Silvester
authors.initials: S
authors.lastname: von Bismarck
authors.forename: Nikolaas M A
authors.initials: NM
authors.lastname: Bax
authors.forename: Andre
authors.initials: A
authors.lastname: Fleer
authors.forename: Michael E
authors.initials: ME
authors.lastname: Höllwarth
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents