title: Hyperbaric oxygen therapy as an adjunctive treatment for sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery.
abstract: OBJECTIVE
  A retrospective study to evaluate the effect of hyperbaric oxygen (HBO2) therapy on sternal infection and osteomyelitis following median sternotomy.
  
  
  METHODS
  A retrospective analysis of patients who received sternotomy and cardiothoracic surgery which developed sternal infection and osteomyelitis between 2002 and 2009. Twelve patients who received debridement and antibiotic treatment were selected, and six of them received additional HBO2 therapy. Demographic, clinical characteristics and outcome were compared between patients with and without HBO2 therapy.
  
  
  RESULTS
  HBO2 therapy did not cause any treatment-related complication in patients receiving this additional treatment. Comparisons of the data between two study groups revealed that the length of stay in ICU (8.7 ± 2.7 days vs. 48.8 ± 10.5 days, p < 0.05), duration of invasive (4 ± 1.5 days vs. 34.8 ± 8.3 days, p < 0.05) and non-invasive (4 ± 1.9 days vs. 22.3 ± 6.2 days, p < 0.05) positive pressure ventilation were all significantly lower in patients with additional HBO2 therapy, as compared to patients without HBO2 therapy. Hospital mortality was also significantly lower in patients who received HBO2 therapy (0 case vs. 3 cases, p < 0.05), as compared to patients without the HBO2 therapy.
  
  
  CONCLUSIONS
  In addition to primary treatment with debridement and antibiotic use, HBO2 therapy may be used as an adjunctive and safe treatment to improve clinical outcomes in patients with sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery.
authors: Department of Respiratory Therapy, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Wen-Kuang
authors: WK
authors: Yu
authors: Yen-Wen
authors: YW
authors: Chen
authors: Huei-Guan
authors: HG
authors: Shie
authors: Te-Cheng
authors: TC
authors: Lien
authors: Hsin-Kuo
authors: HK
authors: Kao
authors: Jia-Horng
authors: JH
authors: Wang
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006348:Cardiac Surgical Procedures; D003131:Combined Modality Therapy; D003646:Debridement; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis / Q000628:therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D056346:Sternotomy; D013530:Surgical Wound Infection / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents