Cardiac Reoperation in a patient who previously underwent omentoplasty for postoperative mediastinitis: a case report

Abstract

Sternal infection has become a rare but challenging problem with significant mortality and morbidity rates since the introduction of sternotomy. Reported rates of mediastinal and sternal infection range from 0.4% to 5%. The ideal reconstruction after sternal debridement is still controversial. Different methods, such as debridement and open packing with continuous antibiotic irrigation, or sternectomy with omental or muscle transposition have been proposed. In this study, we present the cardiac reoperation of a 52 year old man with corrected transposition of great arteries (c-TGA) who had undergone a previous omentoplasty for postoperative mediastinitis.

Descending Necrotizing Cervicomediastinitis Secondary to Esophageal Perforation: Management in a Hospital with Limited Resources

“…A total gastrectomy and thoracostomy in 25% of the patients. Mean acute physiology and chronic health II (APACHE II) score was 13.1 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). The mean risk of death was 17.7% (7.6-29.1%).…”

“…Therefore, any breach of its integrity will be considered an infectious process. 9,[11][12][13] The diagnosis of mediastinitis with immediate infectious signs is present in 31% of the cases; in less than 6 hours infectious signs will be present in 72% of the cases, between 6 and 24 hours, it increases to 87% and in 48 hours, it increases to 97%. As the time to diagnosis and intervention increase infectious signs and the patients in our series presented to our facility late (mean time of 5 days), the infectious process was advanced; therefore, our mortality was 25%.…”

“…With treatment the clinical picture progresses with fever, tachypnea, tachycardia, erythema, crepitation, drainage through the wound and abscess formation (the first three associated with mediastinitis and sepsis). 10,13 PAJT Information collected from our database at trauma and acute care surgery service in a regional hospital (Vicente Corral Moscoso), Cuenca, Ecuador; F: Female; M: Male…”