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

Abstract

Dilute povidone-iodine solution has been widely used as an irrigant for the treatment of mediastinitis. However, its use is not without adverse effects and often cause? poor prowth of pinulation tissues. To avoid the problems seen with the use of povidone-iodine solution, we applied electrolyzed strong acid aqueous solution (ESAAS) to mediastinal irrigation in 4 patients (2 infants and 2 adults) who developed mediastinitis after cardiovascular surgery. According to the "open" method, the mediastinal wound was left open and irrigated with ESAAS 1 to 3 times a day until the infection was eradicated.Mediastinal infection is an uncommon but lifethreatening complication after median sternotomy. The generally accepted method of therapy for this complication consists of antibiotic therapy and surgical treatment including drainage, debridement, and irrigation. Closure of the wound space with musculocutaneous flaps or omentum is also performed as an optional treatment.Povidone-iodine is an excellent bactericidal and fungicidal agent, and its dilute solution (0.5%) has been widely used to irrigate infected tissues (I). The use of povidone-iodine solution is not, however, free from adverse effects. 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.Electrolyzed strong acid aqueous solution (ESAAS) is produced by electrolyzing sodium chloride solution. It has unique and strong sterilizing effects, and no significant deleterious effects due to ESAAS have been re-

Effect of electrolyzed strong acid water on peritoneal irrigation of experimental perforated peritonitis

“…In addition, ESAW has also been applied for the irrigation of body cavities 11−14 and skin ulcers. 22 From the Japan National Cardiovascular Center, Hayashi et al 11 reported four cases of postoperative mediastinitis that was successfully treated with ESAW. They reported that ESAW had no adverse effects, while a satisfactory growth of healthy granulation was also observed during convalescence.…”

“…9,10 However, few applications of body cavity lavage with ESAW in clinical cases have been reported in the literature. 11 −14 In order to establish its safety and effectiveness for peritoneal irrigation in perforated peritonitis, an experimental study was conducted.…”

Effectiveness of Nitazoxanide and Electrolyzed Oxiding Water in Treating Chagas Disease in a Canine Model

“…There is a possibility that NTZ may have caused cardiotoxicity, as reported by Gong et al, who observed that exposure to the drug affected the embryonic heart development of zebrafish, significantly inhibited cardiomyocyte proliferation, and promoted apoptosis, ultimately leading to cardiac tissue injury [ 63 ]. Regarding EOW, this compound has not been reported to aggravate pathological conductive presentations in the heart as part of its acute and chronic side effects [ 64 ].…”

Electrolyzed Saline Irrigation for Elimination of Bacterial Colonization in the Empyema Space

“…Its usefulness was further extended in Japan after several studies used ES to manage mediastinitis after cardiac operations and peritoneal abscess after abdominal operations [15,16]. The ES has been found to promote re-epithelialization, increasing the proliferation of lymphocytes and macrophages associated with collagen deposition for surgical incision healing [14].…”