title: Treatment of deep sternal wound infections post-open heart surgery by application of activated macrophage suspension.
abstract: Postoperative sternal wound infection remains a significant complication and generally causes considerable morbidity and mortality. Macrophages play a major role in the process of wound healing. In order to evaluate the efficacy of local injection of activated macrophage suspensions into open infected sternal wound space, a retrospective case-control study was conducted. Sixty-six patients with deep sternal wound infection treated by activated macrophages (group 1) and 64 patients with deep sternal wound infection treated by sternal reconstruction surgery with various regional flaps (group 2), were matched for gender, age, and risk index. In up to 54 months of follow-up of group 1, 60 patients (91%) achieved complete wound closure. Two (3%) late deaths occurred unrelated to the procedure. Mortality rate in group 2 was 29.7% (19/64). Duration of hospitalization was 22.6 days in group 1 vs. 56.2 days in group 2. Patients with deep sternal wound infection following open heart surgery that were treated by activated macrophages had significantly less mortality as well as significant reduction of hospitalization in comparison to the surgically treated group. These results illustrate the advantages of using a biologically based activated macrophage treatment.
authors.affiliation: Department of Plastic Surgery, Sheba Medical Center, Ramat-Gan, Israel.
authors.forename: Arie
authors.initials: A
authors.lastname: Orenstein
authors.forename: Erez
authors.initials: E
authors.lastname: Kachel
authors.forename: Adi
authors.initials: A
authors.lastname: Zuloff-Shani
authors.forename: Yoav
authors.initials: Y
authors.lastname: Paz
authors.forename: Oren
authors.initials: O
authors.lastname: Sarig
authors.forename: Josef
authors.initials: J
authors.lastname: Haik
authors.forename: Aram K
authors.initials: AK
authors.lastname: Smolinsky
authors.forename: Raphael
authors.initials: R
authors.lastname: Mohr
authors.forename: Eilat
authors.initials: E
authors.lastname: Shinar
authors.forename: David
authors.initials: D
authors.lastname: Danon
mesh_terms: D019264:Adoptive Transfer / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008262:Macrophage Activation / Q000276:immunology; D008264:Macrophages / Q000276:immunology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000209:etiology / Q000628:therapy*; D013908:Thoracotomy / Q000009:adverse effects*; D014945:Wound Healing / Q000276:immunology