title: [Vacuum-assisted closure in a patient with methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after thoracic aortic surgery].
abstract: Mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a serious complication in cardio-thoracic surgery. In mediastinitis cases, acute thoracic aortic graft infection is a lethal status. We described a successful treatment of MRSA thoracic graft infection by V.A.C. ATS therapy. Ascending aortic graft replacement was performed in a 55-year-old man, and deep mediastinitis by MRSA occurred on postoperative day 6. On postoperative day 8, negative pressure wound therapy (NPWT) using a home-made system, was carried out after re-sternotomy, debridement of inflammatory tissues and irrigation. Following the 1st NPWT, V.A.C. ATS therapy was introduced. MRSA vanished from the mediastinum after V.A.C. ATS therapy, and the mediastinum was closed with the omentum. He was discharged 43 days after the 1st operation. We consider that the advantage of V.A.C. ATS therapy is "making a bed-side free status" in even mediastinitis patients, which enables active walking and reinforcement of physical strength. V.A.C. ATS therapy might be useful for the treatment of MRSA mediastinitis.
authors.affiliation: Department of Cardiovascular Surgery, Tomishiro Central Hospital, Tomishiro, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yamauchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Hashimoto
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001807:Blood Vessel Prosthesis; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology* / Q000628:therapy*; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D016459:Prosthesis-Related Infections / Q000628:therapy*