Malin Malmsjö
Professor
Clinical outcome after poststernotomy mediastinitis: Vacuum-assisted closure versus conventional treatment
Author
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
Links
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