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DOI: 10.1055/s-0030-1250335
© Georg Thieme Verlag KG Stuttgart · New York
In Search of a Standardized Treatment for Poststernotomy Mediastinitis
Publication History
received June 9, 2010
Publication Date:
17 January 2011 (online)
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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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