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Poststernotomy mediastinitis: comparison of two treatment modalities

Patrique Segers1, Antonius P de Jong, Jaap J Kloek

  • 1Department of Cardio-thoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. p.segers@amc.uva.nl

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Topical negative pressure (TNP) therapy offers a safe and effective treatment for poststernotomy mediastinitis (PM), a serious complication following heart surgery. This method showed lower infection recurrence and failure rates compared to traditional drainage techniques.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Medical Devices

Background:

  • Poststernotomy mediastinitis (PM) is a severe complication after median sternotomy, with incidence ranging from 0.4-5%.
  • Optimal management strategies for PM remain debated.
  • High morbidity and mortality rates are associated with PM.

Purpose of the Study:

  • To compare the effectiveness of topical negative pressure (TNP) therapy versus traditional closed drainage techniques (CDT) for treating PM.
  • To evaluate outcomes including mortality, infection recurrence, and treatment duration.

Main Methods:

  • Retrospective review of 63 patients treated for PM between 1992 and 2003, following median sternotomy.
  • Patients were divided into two groups: 29 treated with TNP and 34 with CDT.
  • Data collected included treatment modalities, mortality, infection recurrence, therapy duration, and hospital stay.

Main Results:

  • The overall incidence of PM in the study cohort was 0.6%.
  • The TNP group demonstrated significantly lower rates of recurring infection and therapeutic failure (P<0.05).
  • Fewer defects at discharge were observed in the TNP group.

Conclusions:

  • PM is a significant contributor to patient morbidity and mortality.
  • Topical negative pressure (TNP) therapy is a safe and adequate treatment option for poststernotomy mediastinitis.
  • TNP therapy may offer improved outcomes compared to conventional closed drainage techniques.

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