In Search of a Standardized Treatment for Poststernotomy Mediastinitis

I. C. Ennker; A. K. Bär; I. Florath; J. Ennker; P. M. Vogt

doi:10.1055/s-0030-1250335

The Thoracic and Cardiovascular Surgeon, Table of Contents

Thorac Cardiovasc Surg 2011; 59(1): 15-20
DOI: 10.1055/s-0030-1250335

Original Cardiovascular

In Search of a Standardized Treatment for Poststernotomy Mediastinitis

I. C. Ennker¹ ^, ² , A. K. Bär¹ , I. Florath¹ , J. Ennker¹ , P. M. Vogt²

¹MediClin Heart Institute Lahr/Baden, Lahr/Schwarzwald, Germany
²Clinic for Plastic, Chiroplastic and Restorative Surgery, Medical School Hannover, Hannover, Germany

Abstract

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Abstract

Poststernotomy mediastinitis following median sternotomy procedures such as open heart surgery is a rare complication which nevertheless has a mortality rate of up to 50 %. Several treatment options are currently available; however, none of them are standardized. Based on the experience gained from open heart surgery performed at the MediClin Heart Institute Lahr/Baden, a therapeutic algorithm was developed. The treatment steps consist of repeated radical surgical debridement, sternal restabilization, vacuum-assisted closure therapy (VAC) as well as a surgical reconstruction via M. pectoralis plasty (MPP). This approach had a 30-day mortality of 0 % and a hospital mortality of 10.4 %. The approach proved to be safe and advantageous for specific patient groups operated on at the MediClin Heart Institute Lahr/Baden.

Key words

sternotomy - mediastinitis - vacuum therapy - sternal stabilization - therapeutic algorithm

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References

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Dr. Antonia Katharina Bär, Ph.D.

MediClin Heart Institute Lahr/Baden

Hohbergweg 2

77933 Lahr/Schwarzwald

Germany

Phone: +49 7 82 19 25 39 10 45

Fax: +49 7 82 19 25 39 25 00

Email: antonia.baer@mediclin.de