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[Vacuum-assisted closure in a patient with methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after

Akihiko Yamauchi1, Makoto Hashimoto

  • 1Department of Cardiovascular Surgery, Tomishiro Central Hospital, Tomishiro, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|August 7, 2013
PubMed

Insights

Methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after thoracic surgery can be life-threatening. Negative pressure wound therapy, specifically V.A.C. ATS, offers a successful treatment approach for MRSA thoracic graft infections.

Area of Science:

  • Cardiothoracic Surgery
  • Infectious Diseases
  • Wound Healing

Background:

  • Mediastinitis, particularly graft infection by methicillin-resistant Staphylococcus aureus (MRSA), poses a severe risk following cardio-thoracic surgery.
  • Acute thoracic aortic graft infection represents a critical and often lethal complication.

Observation:

  • A case study involving a 55-year-old male patient who developed deep mediastinitis caused by MRSA six days post-ascending aortic graft replacement.
  • Initial treatment included re-sternotomy, debridement, irrigation, and a home-made negative pressure wound therapy (NPWT) system.
  • Subsequently, V.A.C. Advanced Tissue Regeneration (ATS) therapy was implemented.

Findings:

  • V.A.C. ATS therapy led to the eradication of MRSA from the mediastinum.
  • The mediastinum was successfully closed using omentum.
  • The patient was discharged 43 days after the initial surgery, indicating a positive treatment outcome.

Implications:

  • V.A.C. ATS therapy may provide a significant advantage by allowing patients, even those with mediastinitis, greater mobility and improved physical strength.
  • This therapy shows potential as an effective treatment for MRSA mediastinitis, improving patient recovery and quality of life.

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