Mediastinitis and sternal prosthesis infection successfully treated by minimally invasive omental flap transposition
نویسندگان
چکیده
Purulent mediastinitis is a possible serious complication after mediastinal surgery. We report the case of a localized sternal plasmocytoma treated by sternectomy and prosthetic repair, who needed a second surgery for a fistulizing mediastinitis. Five months earlier, in another Hospital, the patient underwent sternal resection and reconstruction with a "sandwich" prosthesis (Methyl-methacrylate and Marlex mesh). Suppurative mediastinitis occurred and septic shock resolution was observed after the spontaneous opening of a mediastinal cutaneous fistula. After referring to our Unit the patient underwent extensive local and systemic preparation and nutritional support; the infected prosthesis was then removed and the gap filled by a laparoscopically-prepared omental flap. Adequate preoperative management, removal of any infected material and minimally invasive omental flap transposition allowed the successful treatment of this life-threatening condition.
منابع مشابه
Sternal Wound Reconstruction With Omental Flap for Poststernotomy Mediastinitis
Figure 1. Mediastinal defect with exposed pros-thetic aortic root graft. DESCRIPTION A 70-year-old woman with short stature and hypermastia underwent ascending aortic aneurysm repair with a prosthetic graft, complicated by postoperative mediastinitis and sternal dehiscence. She was treated with aggressive sternal debridement and negative pressure wound therapy for 1 week (Fig 1) prior to defini...
متن کاملThe role of omental transposition for the management of postoperative mediastinitis: a case series
INTRODUCTION The aim of our study is to present our experience from the management of six patients with deep sternal wood infection and mediastinitis after aortocoronary by pass grafting. CASE SERIES Five Caucasian Greek male patients and a Caucasian Greek female were subjected to aortocoronary by pass grafting. Mean time of sternal dehiscence and mediastinitis was 9-17 (mean 11) days. We man...
متن کاملLaparoscopic Repair of a Subxiphoid Hernia After Omental Flap Reconstruction
Introduction: Hernias anterior to the sternum have rarely been reported and usually occur in the context of abdominal trauma. The literature reports hernia as a complication of omental flap reconstruction, but as yet there is little information on the laparoscopic repair of large subxiphoid hernia resulting from omental flap reconstruction. Case: A 52-year-old woman presented 2 years after surg...
متن کاملSternal reconstruction after post-sternotomy mediastinitis
BACKGROUND Deep sternal wound complications are uncommon after cardiac surgery. They comprise sternal dehiscence, deep sternal wound infections and mediastinitis, which will be treated as varying expressions of a singular pathology for reasons explained in the text. METHODOLOGY AND REVIEW This article reviews the definition, prevalence, risk factors, prevention, diagnosis, microbiology and ma...
متن کاملCardiac Reoperation in a patient who previously underwent omentoplasty for postoperative mediastinitis: a case report
Sternal infection has become a rare but challenging problem with significant mortality and morbidity rates since the introduction of sternotomy. Reported rates of mediastinal and sternal infection range from 0.4% to 5%. The ideal reconstruction after sternal debridement is still controversial. Different methods, such as debridement and open packing with continuous antibiotic irrigation, or ster...
متن کامل