Buradasınız

Kalp Cerrahisi Sonrası Derin Sternal Enfeksiyonların Pektoral Kas Flepleri ile Başarılı Tedavisi

Successful Treatment of Deep Sternal İnfections Following Open Heart Surgery by Pectoralis Major Flaps

Journal Name:

Publication Year:

Abstract (2. Language): 
Severe sternal wound infection following open heart surgery represents a rare but life-threatening complication. It requires prolonged hospitalization and high cost. Debridement and irrigation with saline are the most common used methods for treatment, in case of failure of these treatment regimens, sternal resection and reconstruction with pectoralis muscle flap may be necessary. We reported 4 cases with deep sternal infection after open heart surgery and we introduced our results of strategy on surgical sternal wound debridement and reconstruction with pectoralis major muscle flaps.
Abstract (Original Language): 
Kalp cerrahisi sonrası derin sternal yara enfeksiyonu nadir olmakla beraber, hayatı tehdit eden, hastanede kalış süresini ve maliyeti artıran ağır komplikasyonlardan biridir. Debridman ve yaranın izotonik solüsyon ile yıkanması en sık başvurulan yöntemse de, bu tedavilerin yetersiz kaldığı durumlarda sternal rezeksiyon ve pektoral kas flep rekonstrüksiyonu gerekebilir. Bu yazıda, kardiyak cerrahi sonrası derin sternal enfeksiyon gelişen 4 olguda uyguladığımız cerrahi debridman ve pektoral kas flep rekonstrüksiyonu sonuçlarımızı irdeledik.
115-117

REFERENCES

References: 

1. Gummert JF, Barten MJ, Hans C, Kluge M, Doll N, Walther T, Hentschel B, Schmitt
DV, Mohr FW, Diegeler A. Mediastinitis and cardiac surgery--an updated risk factor
analysis in 10,373 consecutive adult patients. Thorac Cardiovasc Surg 2002;50:87-91.
2. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and management.
Ann Thorac Surg 1996;61:1030-6.
3. Ridderstolpe L, Gill H, Granfeldt H, Ahlfeldt H, Rutberg H. Superficial and deep
sternal wound complications: incidence, risk factors and mortality. Eur J Cardiothorac
Surg 2001;20:1168-75.
4. Toumpoulis IK, Anagnostopoulos CE, Derose JJ Jr, Swistel DG. The impact of deep
sternal wound infection on long-term survival after coronary artery bypass grafting.
Chest 2005;127:464-71.
5. Lu JC, Grayson AD, Jha P, Srinivasan AK, Fabri BM. Risk factors for sternal wound
infection and mid-term survival following coronary artery bypass surgery. Eur J
Cardiothorac Surg 2003;23:943-9.
6. Hollenbeak CS, Murphy DM, Koenig S, Woodward RS, Dunagan WC, Fraser VJ.
The clinical and economic impact of deep chest surgical site infections following
coronary artery bypass graft surgery. Chest 2000;118:397-402.
7. Braxton JH, Marrin CA, McGrath PD, Ross CS, Morton JR, Norotsky M,
Charlesworth DC, Lahey SJ, Clough RA, O'Connor GT; Northern New England
Cardiovascular Disease Study Group. Mediastinitis and long-term survival after
coronary artery bypass graft surgery. Ann Thorac Surg 2000;70:2004-7.
8. De Feo M, Renzulli A, Ismeno G, Gregorio R, Della Corte A, Utili R, Cotrufo M.
Variables predicting adverse outcome in patients with deep sternal wound infection.
Ann Thorac Surg 2001;71:324-31.
9. Kirklin JW, Barratt-Boyes BG, 2nd ed. Cardiac surgery, vol. 1. London:Churchill
Livingstone; 1993. p.224-6.
10. Thurer RJ, Bognolo D, Vargas A, Isch JH, Kaiser GA. The management of
mediastinal infection following cardiac surgery. An experience utilizing continuous
irrigation with povidone-iodine. J Thorac Cardiovasc Surg 1974;68:962-8.
11. Yasuura K, Okamoto H, Morita S, Ogawa Y, Sawazaki M, Seki A, Masumoto H,
Matsuura A, Maseki T, Torii S. Results of omental flap transposition for deep sternal
wound infection after cardiovascular surgery. Ann Surg 1998;227:455-9.
12. Milano CA, Georgiade G, Muhlbaier LH, Smith PK, Wolfe WG. Comparison of
omental and pectoralis flaps for poststernotomy mediastinitis. Ann Thorac Surg
1999;67:377-80.
13. Satta J, Lahtinen J, Raisanen L, Salmela E, Juvonen T. Options for the management
of poststernotomy mediastinitis. Scand Cardiovasc J 1998;32:29-32.
14. El Gamel A, Yonan NA, Hassan R, Jones MT, Campbell CS, Deiraniya AK, Lawson
RA. Treatment of mediastinitis: early modified Robicsek closure and pectoralis major
advancement flaps. Ann Thorac Surg 1998;65:41-6.
15. Klesius AA, Dzemali O, Simon A, Kleine P, Abdel-Rahman U, Herzog C, Wimmer-
Greinecker G, Moritz A. Successful treatment of deep sternal infections following
open heart surgery by bilateral pectoralis major flaps. Eur J Cardiothorac Surg
2004;25:218-23.

Thank you for copying data from http://www.arastirmax.com