Bar-Related Infections After Minimally Invasive Repair of Pectus Excavatum: A 25-Year Single-Center Retrospective...

Area of Science:

• Thoracic Surgery
• Pediatric Surgery
• Infectious Disease

Background:

• The Nuss procedure is a common surgical technique for pectus excavatum.
• Nuss bar infections can lead to complications and prolonged recovery.
• Understanding infection patterns and risk factors is crucial for patient management.

Purpose of the Study:

• To determine the incidence and characteristics of Nuss bar infections.
• To identify factors associated with Nuss bar infections.
• To present institutional management strategies for these infections.

Main Methods:

• Retrospective cohort study of 695 patients undergoing the Nuss procedure (1999-2024).
• Analysis of infection incidence, timing (early vs. late), depth (superficial vs. deep), and associated factors.
• Evaluation of diagnostic methods, microbiology, and impact on surgical outcomes.

Main Results:

• A 4.0% incidence of Nuss bar infections was observed, with a median onset of 2.0 months postoperatively.
• Deep infections (71.4%) more frequently required surgical intervention.
• Bar dislocations (5.6%) and stabilizer plate loosening (1.0%) were significantly associated with infections (P=.001).

Conclusions:

• Bar dislocation and stabilizer plate loosening are key risk factors for Nuss bar infections.
• Management involves accurate diagnostics, tailored antibiotic therapy, and considering alternative diagnoses.
• Prospective validation of institutional management strategies is recommended.