Treatment of deep sternal wound infections post-open heart surgery by application of activated macrophage suspension.
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.
Orenstein
Arie
A
Department of Plastic Surgery, Sheba Medical Center, Ramat-Gan, Israel.
Kachel
Erez
E
Zuloff-Shani
Adi
A
Paz
Yoav
Y
Sarig
Oren
O
Haik
Josef
J
Smolinsky
Aram K
AK
Mohr
Raphael
R
Shinar
Eilat
E
Danon
David
D
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