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[Post-sternotomy mediastinitis treated by omental transposition]
A Yamaguchi1, T Ino, A Mizuhara
1Department of Cardiovascular Surgery, Jichi Medical School, Omiya Medical Center, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|October 1, 1993
Summary
Mediastinitis after cardiac surgery is a serious complication. Early debridement and omental flap transposition effectively manage deep sternal infections, improving patient outcomes.
Area of Science:
- Cardiothoracic Surgery
- Infectious Disease Management
- Surgical Innovation
Context:
- Mediastinitis, a deep sternal infection post-cardiac surgery, presents significant morbidity and mortality.
- A study reviewed 264 patients undergoing cardiac/aortic surgery with median sternotomy between 1989-1992.
- Seven patients (2.6%) developed deep sternal infections with mediastinitis.
Purpose:
- To evaluate the efficacy of debridement, irrigation, and delayed wound closure with omental transposition in treating mediastinitis.
- To identify predisposing factors associated with mediastinitis development.
- To present a surgical technique for omental flap transposition in mediastinitis management.
Summary:
- Six of seven mediastinitis patients were treated with debridement, irrigation, and delayed closure using greater omentum transposition.
- Predisposing factors included cardiac cachexia, prolonged perfusion, and postoperative respiratory insufficiency.
- Five of six treated patients achieved successful wound healing and discharge; one died from adult respiratory distress syndrome.
Impact:
- Early debridement and omental flap transposition demonstrate effectiveness in managing post-cardiac surgery mediastinitis.
- This approach offers a viable solution for deep sternal wound infections.
- Successful wound healing and patient recovery were observed in the majority of treated cases.