Delayed primary versus late secondary wound closure in the treatment of postsurgical sternum osteomyelitis.
Interact Cardiovasc Thorac Surg
; 12(6): 914-8, 2011 Jun.
Article
em En
| MEDLINE
| ID: mdl-21372144
ABSTRACT
Sternal osteomyelitis and poststernotomy mediastinitis is a severe and life-threatening complication after the cardiac surgery. The incidence ranges up to 3% with a mortality rate up to 29%. In addition, postoperative infections after sternotomy are associated with prolonged hospital stay, increased healthcare costs and impaired quality of patient life, representing an economic and social burden. The emergence of increasing antimicrobial resistant bacteria augments the importance of postsurgical infections since the antimicrobial choices are becoming limited. Furthermore, the incidence of infection is an indicator for the quality of patient care in the international benchmark studies. Although several therapy strategies are nowadays present in clinical practice, there is a lack of evidence-based surgical consensus for treatment of this surgical complication. In most cases the poststernotomy mediastinitis involves surgical revision with debridement, open dressing and/or vacuum-assisted therapy. After the granulation tissue on open chest wound is achieved, secondary closure and/or reconstruction with vascularized soft tissue flaps, such as omentum or pectoral muscle is performed. It seems there is a need for more effective surgical treatment of poststernotomy wound infections, which may address the prolonged hospitalization and reduce the number of surgical interventions and with this also the perioperative morbidity. In light of this we propose a randomized study comparing new delayed primary closure of the sternum to the secondary vacuum-assisted closure.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Osteomielite
/
Projetos de Pesquisa
/
Retalhos Cirúrgicos
/
Tratamento de Ferimentos com Pressão Negativa
/
Esternotomia
/
Técnicas de Fechamento de Ferimentos
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Mediastinite
Tipo de estudo:
Clinical_trials
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Interact Cardiovasc Thorac Surg
Ano de publicação:
2011
Tipo de documento:
Article