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Báo cáo y học: "Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition. | Parissis et al. Journal of Cardiothoracic Surgery 2011 6 111 http www.cardiothoracicsurgery.Org content 6 1 111 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition Haralabos Parissis 1 Bassel Al-Alao1 Alan Soo1 David Orr2 and Vincent Young3 Abstract Background To report our experience with Deep mediastinal wound infections DMWI . Emphasis was given to the management of deep infections with omental flaps Methods From February 2000 to October 2007 out of 3896 cardiac surgery patients prospective data collection 120 pts 3.02 developed sternal wound infections. There were 104 males 16 females 73.7 CABG 13.5 Valves 9.32 CABG and Valve. Results Superficial sternal wound infection detected in 68 patients 1.75 and fifty-two patients 1.34 developed DMWI. The incremental risk factors for development of DMWI were Diabetes OR 3.62 CI 1.2-10.98 Pre Op Creatinine 200 gmol l OR 3.33 CI 1.14-9.7 and Prolong ventilation OR 4.16 CI 1.73-9.98 . Overall mortality for the DMWI was 9.3 and the specific mortality of the omental flap group was 8.3 . 19 of the DMWI group developed complications hematoma 6 partial flap loss 3.0 wound dehiscence 5.3 . Mean Hospital Stay 59 21.5 days. Conclusion Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental as is the importance of an aggressive early wound exploration especially for deep sternal infections. Introduction The incidence of mediastinal wound infection in patients undergoing median sternotomy and open-heart surgery can be up to 5 1 2 . A subgroup of 20-30 of those patients 3 develops deep sternal infections with an associated morbidity mortality and cost that remain unacceptably high 4 . There is a considerable lack of consensus regarding the ideal operative treatment of complicated class 2b El Oakley 5 sternal wounds. The .