Document Detail


An effective vacuum-assisted closure treatment for mediastinitis with aortic arch replacement.
MedLine Citation:
PMID:  18495697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Little experience exists with the vacuum-assisted closure (VAC) therapy in the high-risk group of patients with perigraft abscess containing a large amount of prosthetic vascular grafts. We report our experience in the VAC therapy for patients with mediastinitis after aortic arch replacement. Between February 2003 and December 2006, five patients with a mean age of 72.2 years developed postoperative mediastinitis after aortic arch replacement, and were treated with the VAC system. In all the patients the mediastinal fluid and tissue examinations turned out to be negative for microbiological cultures, and successful closure of the midline incision was achieved with concomitant omental transfer after a mean duration of 22.6 days of VAC treatment. Four of the five patients survived to discharge and have been free from recurrent sign of mediastinal or graft infection at long-term follow-up. Our study indicates that the VAC treatment may reduce early mortality of life-threatening deep sternal wound infection complicated by a prior aortic arch replacement and become a preferred therapeutic option for the patients to whom another replacement is too risky.
Authors:
Yoshikatsu Saiki; Shunsuke Kawamoto; Sadahiro Sai; Koichi Tabayashi
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Publication Detail:
Type:  Journal Article     Date:  2008-05-21
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  7     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-30     Completed Date:  2008-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  712-4     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryomachi, Aoba-ku, Sendai 980-8574, Japan. ysaiki@mail.tains.tohoku.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta, Thoracic / radiography,  surgery*
Blood Vessel Prosthesis / adverse effects*
Blood Vessel Prosthesis Implantation / instrumentation*
Female
Humans
Male
Mediastinitis / etiology,  radiography,  surgery*
Middle Aged
Muscle, Skeletal / transplantation
Negative-Pressure Wound Therapy*
Omentum / transplantation
Prosthesis-Related Infections / etiology,  radiography,  surgery*
Sternum / surgery*
Surgical Flaps
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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