Pediatric Cardiology and Cardiac Surgery
Vol.27 No.5 2011 (223-237)
Tomoyuki Katayanagi, Tsukasa Ozawa, Yuki Sasaki, Masanori Hara, Takeshiro Fujii, Noritsugu Shiono, Katsunori Yoshihara, Nobuya Koyama, Yoshinori Watanabe
Division of Cardiovascular Surgery, Toho University Omori Medical Center, Tokyo, Japan
Abstract
Surgical site infection (SSI) is an occasionally unavoidable and challenging postoperative complication that can result in prolongation of hospitalization, increased medical costs, and worsened patient outcomes. In cardiac surgery, some risk factors for SSI have been identified. These include implantation of foreign materials, aortic cross-clamping, and use of cardiopulmonary bypass, all of which have a deleterious effect on the immune system and ultimately increase the risk of postoperative infection.
Mediastinitis is a serious SSI that adversely affects prognosis. Conventional surgical treatments for this complication include debridement, irrigation, and reconstructive surgery using the omentum or some muscle flap. However, the negative pressure wound therapy (NPWT) was recently introduced. Herein, we describe the use of this technique to successfully treat two cases of mediastinitis caused by methicillin-resistant Staphylococcus aureus infection after pediatric open heart surgery, without reoperation for sternal closure. The novel NPWT without sternal reclosure should be effective and less invasive as a surgical treatment for mediastinitis.