Primary treatment of the infected sternotomy wound with muscle flaps: a review of 211 consecutive cases
Between 1978 and 1987, 15,595 median sternotomies were performed at Emory University Hospitals. Sternal wound infections developed in 246 patients (1.6 percent). Mediastinitis was present in 211 patients, while superficial infections were detected in the remaining 35 patients. Debridement and muscle...
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| Veröffentlicht in: | Plastic and reconstructive surgery (1963) 1989-09, Vol.84 (3), p.434-441 |
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| container_title | Plastic and reconstructive surgery (1963) |
| container_volume | 84 |
| creator | NAHAI, F RAND, R. P HESTER, T. R BOSTWICK, J. III JURKIEWICZ, M. J |
| description | Between 1978 and 1987, 15,595 median sternotomies were performed at Emory University Hospitals. Sternal wound infections developed in 246 patients (1.6 percent). Mediastinitis was present in 211 patients, while superficial infections were detected in the remaining 35 patients. Debridement and muscle or omental flap closure were performed in all instances of mediastinitis, with an overall mortality rate of 5.3 percent. The results of this treatment are reviewed, and the evolution of current therapeutic guidelines is described. When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis. |
| doi_str_mv | 10.1097/00006534-198909000-00009 |
| format | Article |
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This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis.</description><identifier>ISSN: 0032-1052</identifier><identifier>EISSN: 1529-4242</identifier><identifier>DOI: 10.1097/00006534-198909000-00009</identifier><identifier>PMID: 2762402</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Biological and medical sciences ; Humans ; Mediastinitis - surgery ; Medical sciences ; Postoperative Complications ; Reoperation ; Retrospective Studies ; Staphylococcal Infections - surgery ; Sternum - surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. 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When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis.</description><subject>Biological and medical sciences</subject><subject>Humans</subject><subject>Mediastinitis - surgery</subject><subject>Medical sciences</subject><subject>Postoperative Complications</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Staphylococcal Infections - surgery</subject><subject>Sternum - surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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The results of this treatment are reviewed, and the evolution of current therapeutic guidelines is described. When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>2762402</pmid><doi>10.1097/00006534-198909000-00009</doi><tpages>8</tpages></addata></record> |
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| identifier | ISSN: 0032-1052 |
| ispartof | Plastic and reconstructive surgery (1963), 1989-09, Vol.84 (3), p.434-441 |
| issn | 0032-1052 1529-4242 |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Biological and medical sciences Humans Mediastinitis - surgery Medical sciences Postoperative Complications Reoperation Retrospective Studies Staphylococcal Infections - surgery Sternum - surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system Surgical Flaps Surgical Wound Infection - surgery |
| title | Primary treatment of the infected sternotomy wound with muscle flaps: a review of 211 consecutive cases |
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