title: Mediastinitis following pediatric cardiac surgery.
abstract: BACKGROUND
  Mediastinitis following pediatric cardiac surgery is associated with significantly high morbidity and mortality.
  
  
  METHODS
  In our review, 21 studies from 1986 to 2011 (12 retrospective studies, eight prospective studies, and a multi-institutional study) including 44,693 pediatric cardiac patients were analyzed.
  
  
  CONCLUSIONS
  Younger age, malnutrition, preoperative respiratory tract infection, high American anesthesiology score, longer duration of surgery, prolonged ventilation, and ICU stay were definite risk factors for mediastinitis. Early primary closure over drains, vacuum-assisted closure, muscle flap, and omental flap remain the most frequently performed treatments for post-sternotomy mediastinitis. Vacuum-assisted closure has emerged as the technique of choice in recent years.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, G.B. Pant Hospital, New Delhi, India.
authors.forename: Chirantan V
authors.initials: CV
authors.lastname: Mangukia
authors.forename: Saket
authors.initials: S
authors.lastname: Agarwal
authors.forename: Subodh
authors.initials: S
authors.lastname: Satyarthy
authors.forename: Vishnu
authors.initials: V
authors.lastname: Datt
authors.forename: Deepak
authors.initials: D
authors.lastname: Satsangi
mesh_terms: D000367:Age Factors; D006348:Cardiac Surgical Procedures; D002648:Child; D004322:Drainage; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay; D044342:Malnutrition; D008480:Mediastinitis / Q000401:mortality* / Q000628:therapy; D054843:Negative-Pressure Wound Therapy; D061646:Operative Time; D011183:Postoperative Complications / Q000401:mortality* / Q000628:therapy; D012141:Respiratory Tract Infections; D012307:Risk Factors; D013524:Surgical Flaps