The role of omental transposition for the management of postoperative mediastinitis: a case series
نویسندگان
چکیده
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 managed these patients with total sternectomy and transposition of the greater omentum in the thorax. All patients had an uneventful postoperative course. CONCLUSION We believe that greater omentum is the ideal reconstruction tissue for deep sternal wound infections and mediastinitis. Timely diagnosis, aggressive sternal debridement and omental flap coverage represent the mainstay of therapy in this highly lethal complication.
منابع مشابه
Cardiac 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 کاملMediastinitis and sternal prosthesis infection successfully treated by minimally invasive omental flap transposition
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...
متن کاملPii: S1010-7940(01)00789-8
A 57-year-old patient underwent prosthetic replacement of a previously implanted ascending aorta graft and developed a periprosthetic purulent collection 1 month later. He was successfully treated by debridement of infected tissues, antiseptic irrigation and transposition of an omental ̄ap. The postoperative course was uneventful. A chest computed tomography scan performed 15 months later showe...
متن کاملSternal 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 کاملMonocular Elevation Deficiency: A Case Series of Surgical Outcome
Background: Inferior rectus recession, Knapp procedure, partial tendon transposition, and combined procedure are different surgical procedures in the management of monocular elevation deficiency (MED). Only a few studies have been published on the management of this problem. In this study, we report our experience with patients with MED focusing on the indications and types of surgery in the so...
متن کامل