title: Clinical outcomes of open heart surgery in patients with atopic dermatitis.
abstract: Atopic dermatitis is a skin condition often complicated by colonization with Staphylococcus aureus, which increases the risk of infective endocarditis, skin cellulitis and osteomyelitis. Positive cultures for Staphylococcus aureus are obtained from 70% to 80% of wounds in patients with mediastinitis. Thus sternotomy carries increased risk of mediastinitis in patients with atopic dermatitis. We retrospectively reviewed 25 patients with atopic dermatitis who underwent cardiac surgery via a median sternotomy or thoracotomy from January 1997 to September 2010 at our institution. Postoperative mediastinitis due to methicillin-resistant Staphylococcus aureus was found in 3 patients who had a median sternotomy. They were ultimately discharged in good condition. No mediastinitis occurred in patients undergoing thoracotomy. Mediastinitis may occur due to direct exposure of the bone marrow to methicillin-resistant Staphylococcus aureus in patients with atopic dermatitis whose skin is colonized with such bacteria. Thoracotomy may be a better surgical approach in patients with atopic dermatitis who require thoracic surgery.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Japan. naotowakimachi@hotmail.co.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yuzaki
authors.forename: Yu
authors.initials: Y
authors.lastname: Shomura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nasu
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000150:complications* / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008480:Mediastinitis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D056346:Sternotomy; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015996:Survival Rate / Q000639:trends; D013908:Thoracotomy; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents