In search of a standardized treatment for poststernotomy mediastinitis.
Poststernotomy mediastinitis following median sternotomy procedures such as open heart surgery is a rare complication which nevertheless has a mortality rate of up to 50 %. Several treatment options are currently available; however, none of them are standardized. Based on the experience gained from open heart surgery performed at the MediClin Heart Institute Lahr/Baden, a therapeutic algorithm was developed. The treatment steps consist of repeated radical surgical debridement, sternal restabilization, vacuum-assisted closure therapy (VAC) as well as a surgical reconstruction via M. pectoralis plasty (MPP). This approach had a 30-day mortality of 0 % and a hospital mortality of 10.4 %. The approach proved to be safe and advantageous for specific patient groups operated on at the MediClin Heart Institute Lahr/Baden.
MediClin Heart Institute Lahr/Baden, Lahr/Schwarzwald, Germany.
I C
IC
Ennker
A K
AK
Bär
I
I
Florath
J
J
Ennker
P M
PM
Vogt
D000368:Aged; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D016022:Case-Control Studies; D003646:Debridement; D004322:Drainage; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D010369:Pectoralis Muscles / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000379:methods; D012015:Reference Standards; D012086:Reoperation; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000150:complications / Q000175:diagnosis / Q000382:microbiology* / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D014945:Wound Healing
D000900:Anti-Bacterial Agents