Mediastinitis after cardiac surgery: risk factors and our vacuum-assisted closure results.

Autor:	Buğra AK; University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Göde S; University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Buğra A; Council of Forensic Medicine, Histopathology Department, Istanbul, Turkey., Eltutan S; University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Arafat Z; Department of Cardiovascular Surgery, University of Health Sciences, Bağcılar Training and Research Hospital, Istanbul, Turkey., Şen O; University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey., Erentuğ V; University of Health Sciences, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery [Kardiochir Torakochirurgia Pol] 2021 Dec; Vol. 18 (4), pp. 195-202. Date of Electronic Publication: 2022 Jan 09.
DOI:	10.5114/kitp.2021.112184
Abstrakt:	Introduction: Mediastinitis after cardiac surgery is a rare complication, but with high morbidity and mortality. Aim: To determine its risk factors and to investigate the efficacy of vacuum-assisted closure (VAC). Material and Methods: Nine thousand one hundred sixty cases of patients who underwent cardiac surgery during 2010-2017 were reviewed retrospectively. One hundred and twenty-seven patients, the case group, were treated by VAC. Three hundred cases with no diagnosis of mediastinitis were selected as the control group. Both groups' clinical and demographic characteristics, preoperative variables, and postoperative follow-up parameters were compared. Factors affecting treatment were analyzed. Results: We found that the presence of diabetes mellitus, bilateral internal thoracic artery and intra-aortic balloon pump usage are independent risk factors for the development of mediastinitis ( p < 0.05). It was found that 74% of tissue cultures were positive and the most common detected organism was Staphylococcus. It was found that many perioperative parameters had a significant effect on the duration of treatment ( p < 0.05). However, regression analysis revealed that bacterial growth was the only independent variable in prolonging the treatment period. Conclusions: We believe that the establishment of perioperative blood glucose regulation, patient selection to use bilateral internal thoracic artery grafts, and maximum attention to sepsis and antisepsis rules in patients who need mechanical support devices such as intra-aortic balloon pump, will significantly reduce the development of mediastinitis. Since we could not find an independent risk factor for the duration of VAC treatment other than culture growth, we think that VAC therapy is successful and safe in the treatment of mediastinitis and should be used more widely. Competing Interests: The authors report no conflict of interest. (Copyright: © 2021 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska).)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu Plný text ve formátu PDF