Treatment of mediastinitis and other complications of sternotomy during cardiac surgery

Guillermo Careaga Reyna; Rogelio Campos Ortega

2010, Number 4

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Cir Gen 2010; 32 (4)

Treatment of mediastinitis and other complications of sternotomy during cardiac surgery

Careaga RG, Campos OR

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Language: Spanish
References: 15
Page: 217-220
PDF size: 168.66 Kb.

ABSTRACT

Objective: To present the experience in the treatment of mediastinitis and other complications of sternotomy.
Setting: Centro Médico Nacional “La Raza”, IMSS. Third level health care center.
Design: Retrospective, transversal, observational.
Statistical analysis: Percentages as a measure of summary for qualitative variables.
Patients and methods: We reviewed the post-sternotomy mediastinitis cases and of sternal dehiscence, infection of the surgical wound, diagnosed according to internationally accepted criteria in patients with cardiac surgery performed between June 1, 2008 and November 30, 2009. Treatment options varied according to the type of detected complication: mechanical lavage, sternal re-suture, use of the vaccum assisted closure (VAC), pectoral muscle or omental flaps.
Results: There were 20 patients with postsurgical infectious pathology (nine men and eleven women), with an average age of 58 years (range, 44 to 72 years). Nine patients coursed with postsurgical mediastinitis. Average in-hospital stay was of 56.5 days (range, 16 to 97 days). Pseudomonas and Staphylococcus aureus predominated, There were three deaths (15%).
Conclusion: Complications of sternotomy, in particular mediastinitis, are severe with high mortality and prolonged in-hospital stay, and require immediate and aggressive treatment. Results of our series are comparable to results from other health care centers.

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