کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4117478 1270307 2015 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Rigid sternal fixation in the management of pediatric postmedian sternotomy mediastinitis: A 20-year study
ترجمه فارسی عنوان
تثبیت سینه سفت و سخت در مدیریت استریتومی مدیاستنیت پست مدیا کودکان: یک مطالعه 20 ساله
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری های گوش و جراحی پلاستیک صورت
چکیده انگلیسی

SummaryBackground and aimPediatric patients are at a risk of mediastinitis, a life-threatening complication of median sternotomy, following cardiac surgery for congenital conditions. Our experience with rigid internal sternal fixation in pediatric patients with postmedian sternotomy mediastinitis is presented.Methods and materialsA retrospective chart review was performed of patients <18 years of age diagnosed with postoperative mediastinitis between January 1, 1990 and December 31, 2009. Charts were reviewed for demographic data, cardiac history, causative microorganism, and infectious risk factors. The methods of surgical intervention including flap coverage and use and type of sternal plating (resorbable and/or titanium) were also recorded. The primary end point of interest was overall survival.ResultsTwenty-five pediatric patients were diagnosed with postoperative mediastinitis. Rigid fixation of the sternum following debridement was performed in 20 patients (age range: 1 month–18 years), all of whom successfully tolerated the procedure. Resorbable plates were used in 13 patients. Five patients did not undergo rigid fixation due to either serious ill-health or lack of adequate sternal bone stock. No patient experienced recurrent sternal wound infection. A total of 20 patients (80%) survived to discharge. Three patients succumbed to their heart condition prior to rigid fixation, one died following sternal closure from unrelated causes, and one patient was lost to follow-up.ConclusionsPost-sternotomy mediastinitis in pediatric patients may be addressed using wide debridement, rigid sternal fixation, and flap coverage. In our series of 25 patients with pediatric mediastinitis, none died from mediastinitis. Placement of hardware did not adversely affect patient survival. This study demonstrates the feasibility of rigid sternal fixation.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Plastic, Reconstructive & Aesthetic Surgery - Volume 68, Issue 12, December 2015, Pages 1656–1661
نویسندگان
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