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Published on: February 9, 2011

Mediastinal wound infections following pediatric cardiac surgery

Charles B Huddleston1

  • 1Division of Cardiothoracic Surgery Washington University School of Medicine St. Louis Children's Hospital, St. Louis, MO, USA. huddlestonc@msnotes.wustl.edu

Seminars in Thoracic and Cardiovascular Surgery
|September 16, 2004
PubMed

Insights

Deep sternal wound infections in children and neonates are common, often caused by Staphylococcal species. Risk factors differ between age groups, and novel treatments like debridement and primary closure are emerging.

Area of Science:

  • Pediatric Surgery
  • Infectious Diseases
  • Cardiothoracic Surgery

Background:

  • Deep sternal wound infections (DSWI) present a significant complication in pediatric and neonatal cardiac surgery.
  • The incidence of DSWI in younger populations mirrors that in adults, with Staphylococcal species being the predominant pathogens.

Purpose of the Study:

  • To delineate the distinct risk factors for DSWI in pediatric and neonatal populations.
  • To compare the etiological agents and therapeutic approaches for DSWI in children versus adults.

Main Methods:

  • Review of pediatric and neonatal cases with DSWI.
  • Analysis of causative organisms and identified risk factors.
  • Evaluation of treatment outcomes for conventional and emerging therapies.

Main Results:

  • Staphylococcal species are the primary causative agents in both pediatric and adult DSWI.
  • Pediatric-specific risk factors include leaving the sternum open post-repair, nasal Staphylococcal colonization, and re-exploration for bleeding.
  • Adult risk factors involve diabetes mellitus and internal mammary artery graft use.

Conclusions:

  • DSWI management in children shares similarities with adult protocols but presents unique risk factors.
  • Emerging therapeutic strategies, including debridement and primary sternal closure, show promise for DSWI treatment in pediatric patients.

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