title: Vacuum-assisted closure system in treatment of postoperative mediastinitis.
abstract: OBJECTIVE
  Post-cardiac surgery mediastinitis is a serious complication with high morbidity and high financial costs. Using a vacuum-assisted closure system is the established line of treatment for mediastinitis, which improves outcome, especially in the high-risk group of patients.
  
  
  METHODS
  From January 2007 to April 2011, a retrospective study was carried out to evaluate the outcome of vacuum-assisted closure in the treatment of postoperative mediastinitis.
  
  
  RESULTS
  There were 34 patients; 27 were male and 7 female. Mean time from infection to vacuum-assisted closure was 3.34 ± 1.10 days. The duration of vacuum-assisted closure was 6.51 ± 1.85 days (3-9 days). The mean amount of discharge was 759.60 ± 175.28 mL (range, 354-990 mL). Of the 34 patients, 21 (61.76%) had direct surgical wound closure and 13 (41.16%) had re-wiring. Two patients had bilateral pectoral flaps. One patient had chronic fistula formation, and one had a tear in the right ventricle. Mean hospital stay was 11.28 ± 2.09 days (range, 6-16 days).
  
  
  CONCLUSIONS
  Vacuum-assisted closure therapy is a safe, reliable, and cost-effective modality of treatment for postoperative mediastinitis. It improves the outcome and can be combined with other modalities of conventional treatment, especially in high-risk groups such as the elderly or patients with diabetes.
authors.affiliation: Department of Cardiac Surgery, Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia. Cardiothoracic Surgery Department, Banha Faculty of Medicine, Banha University, Egypt
authors.forename: Mohamed Ahmed
authors.initials: MA
authors.lastname: Elawadi
authors.forename: Farouk
authors.initials: F
authors.lastname: Oueida
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008480:Mediastinitis / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000009:adverse effects; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac surgical procedures; Negative-pressure wound therapy; Postoperative complications; Sternum; Surgical wound infection; mediastinitis