title: Mediastinitis and sternal prosthesis infection successfully treated by minimally invasive omental flap transposition.
abstract: Purulent mediastinitis is a possible serious complication after mediastinal surgery. We report the case of a localized sternal plasmocytoma treated by sternectomy and prosthetic repair, who needed a second surgery for a fistulizing mediastinitis. Five months earlier, in another Hospital, the patient underwent sternal resection and reconstruction with a "sandwich" prosthesis (Methyl-methacrylate and Marlex mesh). Suppurative mediastinitis occurred and septic shock resolution was observed after the spontaneous opening of a mediastinal cutaneous fistula. After referring to our Unit the patient underwent extensive local and systemic preparation and nutritional support; the infected prosthesis was then removed and the gap filled by a laparoscopically-prepared omental flap. Adequate preoperative management, removal of any infected material and minimally invasive omental flap transposition allowed the successful treatment of this life-threatening condition.
authors: Thoracic Surgery Unit, University of Perugia Medical School, Ospedale S, Maria della Misericordia, 06134 Perugia, Italy.
authors: Valentina
authors: V
authors: Tassi
authors: Silvia
authors: S
authors: Ceccarelli
authors: Jacopo
authors: J
authors: Vannucci
authors: Francesco
authors: F
authors: Puma
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000473:pathology / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D009852:Omentum / Q000601:surgery*; D010954:Plasmacytoma / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000382:microbiology / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013249:Sternum / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000382:microbiology / Q000601:surgery*; D013899:Thoracic Neoplasms / Q000601:surgery