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Ann Thorac Surg 1996;62:1412-1416
© 1996 The Society of Thoracic Surgeons

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Original Article: Cardiovascular

Diagnosing Sternal Wound Infections With ^99mTc-Labeled Monoclonal Granulocyte Antibody Scintigraphy

Departments of Thoracic Surgery, Infectious Diseases, Diagnostic Radiology, and Hospital Physics, Karolinska Hospital, Stockholm, Sweden

Accepted for publication June 14, 1996.

Background. Postoperative mediastinitis is a serious complication of thoracic operations. The diagnosis can sometimes be difficult, especially in cases with subacute clinical presentation. The aim of this study was to assess the clinical use of granulocyte scintigraphy and tomography in the diagnosis of postoperative wound infection and mediastinitis.

Methods. Twenty-nine patients after cardiothoracic operations were included, of whom 5 patients with a normal postoperative course formed the control group. We injected technetium 99m-monoclonal antigranulocyte antibodies and performed single-photon emission computed tomography after 4 and 20 hours.

Results. Twenty-three patients had both the early and the later scan; the remaining 6 had only the early scan. Seven scans indicated infection: 3 cases of mediastinitis, 2 cases of superficial wound infection, 1 case of infection in a synthetic aortic graft, and 1 case of osteitis. All were verified by bacterial culture. There was one false-negative scan; this patient had only the early registration and then was explored.

Conclusions. This method when combined with the tomographic scan option is able to distinguish between deep and superficial infections. Two registrations must be made for optimal results.

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Invited Commentary

David A. Browdie and R. Varick Bernstein
Ann. Thorac. Surg. 1996 62: 1416-1417. [Extract] [Full Text]

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