ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
David B. Ross
Ivan M. Rebeyka
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Al-Sehly, A. A.
Right arrow Articles by Rebeyka, I. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Al-Sehly, A. A.
Right arrow Articles by Rebeyka, I. M.
Related Collections
Right arrow Cardiac - other

Ann Thorac Surg 2005;80:2314-2320
© 2005 The Society of Thoracic Surgeons

Original article: Cardiovascular

Pediatric Poststernotomy Mediastinitis

Abdullah A. Al-Sehly, MD a , Joan L. Robinson, MD a , * , Bonita E. Lee, MD a , Geoff Taylor, MD c , David B. Ross, MD b , Murray Robertson, MD a , Ivan M. Rebeyka, MD b

a Department of Pediatrics and Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
b Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
c Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

Accepted for publication May 12, 2005.

* Address correspondence to Dr Robinson, Stollery Children's Hospital, 2C3 Walter MacKenzie Centre, 8440-112 St, Edmonton, AB, T6G 2B7, Canada (Email: jr3{at}ualberta.ca).

BACKGROUND: Mediastinitis results in significant morbidity in pediatric cardiac patients. It is not clear whether delayed sternal closure is a risk factor for these infections. Management of mediastinitis remains controversial.

METHODS: Cases of mediastinitis at the Stollery Children's Hospital from January 1, 1991, to June 30, 2004, were reviewed.

RESULTS: There were 29 cases of mediastinitis in 2,675 open cardiac procedures for an overall incidence of 1.1%. Infection was diagnosed 5 to 27 days after the original surgical procedure (median, 10 days). The odds ratio for infection with delayed sternal closure versus primary sternal closure was 1.88 (95% confidence interval, 0.63 to 5.60). Signs at the onset of infection included fever (86%), incisional erythema (69%), purulent drainage from the incision or pacer wire sites (83%), and wound dehiscence (23%). Debridement was followed by primary sternal closure in all but three cases in which the sternum had not been closed before debridement and rotational muscle flaps were not used. Continuous irrigation systems were used only in the first 7 patients. One patient died of mediastinitis complicated by infective endocarditis, and 2 patients died of multiorgan failure.

CONCLUSIONS: Delayed sternal closure was not a major risk factor for mediastinitis, especially if primary skin closure was used with delayed sternal closure. Excellent results were attained with debridement and primary closure of these infections.




This article has been cited by other articles:


Home page
 J. Thorac. Cardiovasc. Surg.Home page
N. Roy, I. M. Rebeyka, J. Atallah, and D. B. Ross
Rapid extracorporeal life support rescue in patients undergoing the Norwood procedure.
J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 765 - 766.
[Full Text] [PDF]

Home page
 RadiologyHome page
A. M. Gaca, J. J. Jaggers, L. T. Dudley, and G. S. Bisset III
Repair of Congenital Heart Disease: A Primer-Part 1
Radiology, June 1, 2008; 247(3): 617 - 631.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
T. Kadohama, N. Akasaka, A. Nagamine, K. Nakanishi, K. Kiyokawa, K. Goh, and T. Sasajima
Vacuum-Assisted Closure for Pediatric Post-Sternotomy Mediastinitis: Are Low Negative Pressures Sufficient?
Ann. Thorac. Surg., March 1, 2008; 85(3): 1094 - 1096.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
C. Anslot, S. Hulin, and Y. Durandy
Postoperative Mediastinitis in Children: Improvement of Simple Primary Closed Drainage
Ann. Thorac. Surg., August 1, 2007; 84(2): 423 - 428.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The Society of Thoracic Surgeons.