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Ann Thorac Surg 2003;76:2104-2106
© 2003 The Society of Thoracic Surgeons

Case report

New strategy for treatment of MRSA mediastinitis: one-stage procedure for omental transposition and closed irrigation

Nobuaki Hirata, MDa*, Shinichi Hatsuoka, MDa, Akira Amemiya, MDa, Takayoshi Ueno, MDa, Yoshio Kosakai, MDa

a Division of Cardiovascular Surgery, Takarazuka Municipal Hospital, Takarazuka, Hyogo, Japan

Accepted for publication April 23, 2003.

* Address reprint requests to Dr Hirata, Division of Cardiovascular Surgery, Takarazuka Municipal Hospital, 4-5-1, Kohama, Takarazuka, Hyogo 665-0827, Japan
e-mail: hirata{at}xd5.so-net.ne.jp

Mediastinitis due to methicillin-resistant Staphylococcus aureus is a devastating potential complication of cardiac surgery. We treated 4 patients with this condition using a new technique. First we performed an early radical removal of infected tissue and omental transposition with direct primary closure of the sternum and closed continuous irrigation with saline/vancomycin hydrochloride; that was followed by an administration of intravenous antibiotics. We obtained good clinical results, which are reported herein along with the clinical courses.




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