Management of Postoperative Mediastinitis in Infants and Children by Muscle Flap Rotation

Bilateral Pectoral Myocutaneous Advancement Flaps and Anatomic Sternal Wound Reconstruction in Cyanotic Infants with Mediastinitis

“…In recent series, the incidence of deep sternal wound infection in pediatric cardiac surgical patients varies from 0.5% to 2.0%. 14,[17][18][19][20] Similar figures (0.9% to 1.6%) are cited for adult patients. 1,2,11,12 Risk factors for sternal wound infection in children include longer preoperative hospital stay, higher preoperative ASA score, postoperative low cardiac output, excessive bleeding requiring reexploration, and duration of ventilator dependence following cardiac repair.…”

“…In recent series, the incidence of deep sternal wound infection in pediatric cardiac surgical patients varies from 0.5% to 2.0% 14 , 17‐20 . Similar figures (0.9% to 1.6%) are cited for adult patients 1,2 , 11,12 .…”

“…11,23 Experience from adults can be applied to children. In the five published reports on pediatric sternal wound reconstruction [14][15][16][17][18] there are only 33 cardiac cases reported ( Table 2). It is also a heterogeneous population (age range: 1 day to 10 years), and the majority of the children had undergone definitive correction of their cardiac anomalies.…”

Successful Treatment of Mediastinitis after Cardiovascular Surgery Using Electrolyzed Strong Acid Aqueous Solution

“…Wound irrigation and dressing changes are continued until the infection is eradicated, and a delayed primary closure is performed (8). Reconstruction using musculocutaneous flaps or omentum is also attempted to close the mediastinal space as an option of secondary closure (4,(9)(10)(11)(12). The advantage of this technique includes the elimination of a potentially undrained space and active debridement by irrigation and dressing changes during convalescence.…”

“…Growth of granulation tissues is often impeded because povidone-iodine can substantially damage underlying healthy tissues. Thyroid dysfunction ( 2 ) , electrolyte derangement, metabolic acidosis (3,4), and restrictive pericarditis ( 5 ) have also been reported as toxic or adverse effects attributed to the use of povidoneiodine solution.…”