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Professor Malin Malmsjö, MD, PhD. Photo.

Malin Malmsjö

Professor

Professor Malin Malmsjö, MD, PhD. Photo.

Clinical outcome after poststernotomy mediastinitis: Vacuum-assisted closure versus conventional treatment

Author

  • Johan Sjögren
  • Ronny Gustafsson
  • Johan Nilsson
  • Malin Malmsjö
  • Richard Ingemansson

Summary, in English

Background. The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. Methods. One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April 2004 and was 100% complete. Actuarial statistics were used to calculate the survival rates. Results. The 90-days mortality was 0% in the vacuum-assisted closure group and 15% in the conventional treatment group (p < 0.01). The failure rate to first-line treatment with vacuum-assisted closure and conventional treatment were 0% and 37.5%, respectively (p < 0.001). There was no statistically significant difference in the recurrence of sternal fistulas after vacuum-assisted closure therapy or conventional treatment: 6.6% versus 5.0%, respectively. Overall survival in the vacuum-assisted closure group was significantly better (p < 0.05) than in the conventional treatment group: 97% versus 84% (6 months), 93% versus 82% (1 year), and 83% versus 59% (5 years). Conclusions. Our findings support that vacuum-assisted closure therapy is a safe and reliable option in poststernotomy mediastinitis with excellent survival and a very low failure rate compared with conventional treatment.

Department/s

  • Thoracic Surgery
  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)
  • Heart and Lung transplantation
  • Section II

Publishing year

2005

Language

English

Pages

2049-2055

Publication/Series

Annals of Thoracic Surgery

Volume

79

Issue

6

Document type

Journal article

Publisher

Elsevier

Topic

  • Surgery
  • Cardiac and Cardiovascular Systems

Status

Published

Research group

  • Artificial Intelligence and Bioinformatics in Cardiothoracic Sciences (AIBCTS)
  • Heart and Lung transplantation

ISBN/ISSN/Other

  • ISSN: 1552-6259