Should an infected Nuss bar be removed?

Renterghem, Katrien M. Van; Bismarck, S. von; Bax, N. M. A.; Fleer, A.; Höllwarth, Michael E.

doi:10.1016/j.jpedsurg.2004.12.005

Cited by 35 publications

(17 citation statements)

References 14 publications

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“…One was am ild superficial infection which healed with conservative local and antibiotic treatment, while the other one required bar removal after 4m onths of conservative treatment. The removal of the bar may have been an unnecessary procedure and the infection could have healed with proper surgical drainage and long-term antibiotics, as mentioned by many authors (28,29,30).…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Repair for Treating Pectus Excavatum — Early Results

2008

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Results: operative mortality was zero and there were no clinically significant bleeding complications. epidural analgesia was necessary for adequate pain control. small symp tomless residual pneumothoraxes and pleural effusions were common after the operation but neither required intervention. one patient had ah emothorax 7m onths postopera tively,which was cured with asingle puncture. bar displacement took place in 2patients but required correction in only one of these patients. there were 2wound infections, one superficial and one which led to removal of the bar was 6m onths after the operation. this may have been unnecessary.t wo patients had pneumonia, one probably unrelated to the operation. one patient required psychiatric ward treatment, and 3p atients had mild psychological symptoms not requiring specific therapy.t he preliminary cosmetic results were good or excellent in 90% of the cases, but alonger followup is needed for information on the final outcome.Conclusions: Mirpe is as afe operation and gives ac osmetically good result. thora coscopy is needed during the operation. the early postoperative period in hospital is painful and there the patients need intensive care. We found the high epidural analgesia beneficial and safe during early period of pain treatment. the bar is removed not earlier than 3years after the operation as aday care surgical procedure.

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Section: Discussionmentioning

confidence: 99%

Minimally Invasive Repair for Treating Pectus Excavatum — Early Results

2008

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“…The infectious complication rate in the study from Graz and Utrecht was 6.8%. The bar had to be removed only in one case (37).…”

Section: Discussionmentioning

confidence: 99%

The Nuss Procedure for the Correction of Pectus Excavatum

Bohosiewicz¹,

Kudela²,

Izwaryn³

2009

Polish Journal of Surgery

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Pectus excavatum is one of the most common chest malformation. It occurs 4-5 times more often in boys. Familiar occurrence of the malformation has been observed. Two surgical techniques have been performed predominantly: the Ravitch method (1949) with further modifications and the Nuss minimally invasive method (1998). The aim of the study was presentation of our own, slightly modified surgical technique, its results and original analgesia method in early postoperative period. results. Very good result was achieved in 72%, good in 22% and bad in 5%. No mortality and inner organ injuries were noticed. Minor complications occurred in 12% of children. conclusions. The Nuss procedure for the correction of pectus excavatum gives good and very good results in 94% of children. The minimal invasiveness of this method allows to use this method for minor defects. The limitation of this technique is asymmetric defect in which the Ravitch procedure is still the method of choice.

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“…Very few heart lesions and deaths were reported, mainly in cases of procedure done without thoracoscopy (Moss et al, 2001;Nuss, 2008). In case of Nuss bar infection, this can be managed successfully conservatively (Van Renterghem et al, 2005). Recurrence is reported in a range between 2% and 5% (Kelly et al, 2010;Lopushinsky & Fecteau, 2008).…”

Section: Diagnostic Assessment and Classificationmentioning

confidence: 99%