Machín RJC, Castillo MJM, Torralbas RFE

Language: Spanish
References: 9
Page: 633-637
PDF size: 1263.76 Kb.

ABSTRACT

Acute mediastinitis is a complication of the heart surgery, which shows high mortality and it always requires surgical treatment, of which several therapeutic modalities exist. Decisions are complicated, for this reason the establishment of a therapeutic algorithm that allows to reduce mortality due to this complication is necessary. The great variability of the results and the spectrum of surgical techniques described on this respect, have attempted against the creation of practical guides based on the evidence for the postoperative mediastinal infection, in such way that the few algorithms that have been published are incomplete or very specific. A therapeutic algorithm is presented for the acute mediastinitis, elaborated in the Cardiology Center from Santiago de Cuba, it is of easy application. It decreased mortality and can be applied in the rest of the centers from the country, which don't have a similar tool.

REFERENCES

1. Filsoufi F, Castillo JG, Rahmanian PB, Broumand SR, Silvay G, Carpentier A, et al. Epidemiology of deep sternal wound infection in cardiac surgery. J Cardiothorac Vasc Anesth. 2009;23(4):488-94.

2. Steingrimsson S, Gottfredsson M, Kristinsson KG, Gudbjartsson T. Deep sternal wound infections following open heart surgery in Iceland: a population-based study. Scand Cardiovasc J. 2008;42(3):208-13.

3. Cowan KN, Teague L, Sue SC, BS, Mahoney JL. Vacuum-assisted wound closure of deep sternal infections in high-risk patients after cardiac surgery. Ann Thorac Surg. 2005;80(6):2205-12.

4. Poncelet AJ, Lengele B, Delaere B, Zech F, Glineur D, Funken JC, et al. Algorithm for primary closure in sternal wound infection: a single institution 10 year experience. Eur J Cardiothorac Surg. 2008;33(2):232-8.

5. Sjögren J, Malmsjö M, Gustafsson R, Ingemansson R. Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm. Eur J Cardiothorac Surg. 2006;30(6):898–05.

6. Ennker C, Bär AK, Florath I, Ennker J, Vogt PM. In search of a standardized treatment for poststernotomy mediastinitis. Thorac Cardiov Surg. 2011;59(1):15–20.

7. Saadi A, Perentes JY, González M, Tempia AC, Wang Y, Demartines N, et al. Vacuum-assisted closure device: a useful tool in the management of severe intrathoracic infections. Ann Thorac Surg. 2011;91(5):1582-9.

8. Gaudreau G, Costache V, Houde C, Cloutier D, Montalin L, Voisine P, et al. Recurrent sternal infection following treatment with negative pressure wound therapy and titanium transverse plate fixation. Eur J Cardiothorac Surg. 2010; 37(4):888-92.

9. Moreschi AH, Macedo Neto AV, Barbosa GV, Saueressig MG. Aggressive treatment using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy. J Bras Pneumol. 2008;34:654-60.