Surgical debridement, vacuum therapy and pectoralis plasty in poststernotomy mediastinitis

Ennker, I. C.; Pietrowski, Detlef; Vöhringer, Luise; Kojcici, B; Albert, Alexander; Vogt, Peter M.; Ennker, J.

doi:10.1016/j.bjps.2008.05.017

Cited by 45 publications

(55 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At 9.2% (n = 12), the in-hospital mortality rate for the total cohort was similar to that reported in the literature. 10) As with any surgical procedure, the flap reconstruction is not free of complications. However, it is reliable and able to provide a reduced morbidity and mortality for cases where the TNP therapy alone is not enough to heal the DSWI defect.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis

Juhl

Hody

Videbaek

et al. 2017

ATCS

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

“…In these cases, TNP therapy has come to serve as a bridge to sternal reconstruction with flap coverage. [9][10][11] Thus, despite the recent trend toward TNP-based treatment, flap reconstruction still plays a key role for a subset of DSWI patients.…”

mentioning

confidence: 99%

Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis

Juhl

Hody

Videbaek

et al. 2017

ATCS

View full text Add to dashboard Cite

“…The unsatisfactory results of these different approaches increased interest in plastic procedures as alternative treatments [6,79,84] . Bilateral pectoralis muscle flaps, as either advancement or turnover flaps, are the most usual plastic procedures in the dealing of DSWI [16,85] . This surgical management has a quite low mortality rate but carries a series of disadvantages, including KPa); this system holds the incision edges together, reduces lateral tension and edema, stimulates perfusion, and protects the surgical site from external infectious sources [110] .…”

Section: Managementmentioning

confidence: 99%

“…Several recent studies, meta-analyses, and systematic reviews have validated the efficacy of NPWT in DSWI either as a single-line therapy, or as a "bridge" prior to final surgical closure [93][94][95][96][97] . This wound-healing technique is based on the application of continuous or intermittent negative pressure to a wound, which results in arteriolar dilatation and, subsequently, determines wound perfusion and granulation tissue proliferation [57,85,93] . In vitro and clinical studies designed to determine the effect of NPWT lent convincing evidence of efficacy and safety in term of decrease of edema, exudation, and microbial colonization as well as reduction of inflammatory cytokine release [57,85,[98][99][100] .…”

mentioning

confidence: 99%

“…This wound-healing technique is based on the application of continuous or intermittent negative pressure to a wound, which results in arteriolar dilatation and, subsequently, determines wound perfusion and granulation tissue proliferation [57,85,93] . In vitro and clinical studies designed to determine the effect of NPWT lent convincing evidence of efficacy and safety in term of decrease of edema, exudation, and microbial colonization as well as reduction of inflammatory cytokine release [57,85,[98][99][100] . In case of diagnosis of DSWI, an early application of NPWT was associated to a faster healing and an increased likelihood of survival [18,97,101,102] .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Deep sternal wound infection after cardiac surgery: Evidences and controversies

Cotogni

Barbero

Rinaldi

2015

WJCCM

View full text Add to dashboard Cite

Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid-and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at highrisk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors -when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. Core tip: Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections due to increasing length of stay, costs, and mortality. In particular, deep sternal wound infection (DSWI) is a worrying complication after cardiac surgery, with a still relevant incidence. Unfortunately, DWSI appearance is related to a wide number of both patient and surgical factors. This review may be useful for guiding physicians to the knowledge of main risk factors and the choice of the appropriate management of DWSIs with the aim of reducing the rate of this potentially devastating complication in cardiac surgery patients.Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infection after cardiac surgery: Evidences and controversies. World J Crit Care Med 2015; 4(4): 265-273 Available from: URL: http:// www.wjgnet.com/2220-3141/full/v4/i4/265.htm DOI: http:// dx.doi.org/10.5492/wjccm.v4.i4.265 INTRODUCTIONDeep sternal wound infection (DSWI) is one of the most complex and potentially devastating complications following median sternotomy in cardiac surgery with a significant impact on both patient prognosis and hospital budgets [1][2][3][4][5] . Despite many advances in prevention, it still remains significant and ranges between 0.5% and 6.8% [6][7][8][9][10] , with in-hospital mortality rates between 7% and 35% [2,3,7,9,[11][12][13] . Moreover, mid-and long-term survival is significantly reduced in patients that have experienced DSWI. By the end of the first year, Filsoufi et al [6] found a 15% absolute survival difference between patients ...

show abstract

Rekonstruktion der Thoraxwand

Vogt

2011

Praxis Der Plastischen Chirurgie

View full text Add to dashboard Cite

Surgical debridement, vacuum therapy and pectoralis plasty in poststernotomy mediastinitis

Cited by 45 publications

References 15 publications

Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis

Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis

Deep sternal wound infection after cardiac surgery: Evidences and controversies

Rekonstruktion der Thoraxwand

Contact Info

Product

Resources

About