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Does method of sternal repair influence long-term outcome of postoperative mediastinitis?

Publication ,  Journal Article
Atkins, BZ; Onaitis, MW; Hutcheson, KA; Kaye, K; Petersen, RP; Wolfe, WG
Published in: Am J Surg
November 2011

BACKGROUND: Post-sternotomy mediastinitis reduces survival after cardiac surgery, potentially further affected by details of mediastinal vascularized flap reconstruction. The aim of this study was to evaluate survival after different methods for sternal reconstruction in mediastinitis. METHODS: Two hundred twenty-two adult cardiac surgery patients with post-sternotomy mediastinitis were reviewed. After controlling infection, often augmented by negative pressure therapy, muscle flap, omental flap, or secondary closure was performed. Outcomes were reviewed and survival analysis was performed. RESULTS: Baseline characteristics were similar. In-hospital mortality (15.7%) did not differ between groups. Secondary closure was correlated with negative pressure therapy and reduced length hospital of stay. Recurrent wound complications were more common with muscle flap repair. Survival was unaffected by sternal repair technique. By multivariate analysis, heart failure, sepsis, age, and vascular disease independently predicted mortality, while negative pressure therapy was associated with survival. CONCLUSIONS: Choice of sternal repair was unrelated to survival, but mediastinal treatment with negative pressure therapy promotes favorable early and late outcomes.

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Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

November 2011

Volume

202

Issue

5

Start / End Page

565 / 567

Location

United States

Related Subject Headings

  • Vascular Diseases
  • Surgical Flaps
  • Surgery
  • Sternum
  • Sternotomy
  • Sepsis
  • Retrospective Studies
  • Negative-Pressure Wound Therapy
  • Multivariate Analysis
  • Mediastinum
 

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ICMJE
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Atkins, B. Z., Onaitis, M. W., Hutcheson, K. A., Kaye, K., Petersen, R. P., & Wolfe, W. G. (2011). Does method of sternal repair influence long-term outcome of postoperative mediastinitis? Am J Surg, 202(5), 565–567. https://doi.org/10.1016/j.amjsurg.2011.06.013
Atkins, B Zane, Mark W. Onaitis, Kelley A. Hutcheson, Keith Kaye, Rebecca P. Petersen, and Walter G. Wolfe. “Does method of sternal repair influence long-term outcome of postoperative mediastinitis?Am J Surg 202, no. 5 (November 2011): 565–67. https://doi.org/10.1016/j.amjsurg.2011.06.013.
Atkins BZ, Onaitis MW, Hutcheson KA, Kaye K, Petersen RP, Wolfe WG. Does method of sternal repair influence long-term outcome of postoperative mediastinitis? Am J Surg. 2011 Nov;202(5):565–7.
Atkins, B. Zane, et al. “Does method of sternal repair influence long-term outcome of postoperative mediastinitis?Am J Surg, vol. 202, no. 5, Nov. 2011, pp. 565–67. Pubmed, doi:10.1016/j.amjsurg.2011.06.013.
Atkins BZ, Onaitis MW, Hutcheson KA, Kaye K, Petersen RP, Wolfe WG. Does method of sternal repair influence long-term outcome of postoperative mediastinitis? Am J Surg. 2011 Nov;202(5):565–567.
Journal cover image

Published In

Am J Surg

DOI

EISSN

1879-1883

Publication Date

November 2011

Volume

202

Issue

5

Start / End Page

565 / 567

Location

United States

Related Subject Headings

  • Vascular Diseases
  • Surgical Flaps
  • Surgery
  • Sternum
  • Sternotomy
  • Sepsis
  • Retrospective Studies
  • Negative-Pressure Wound Therapy
  • Multivariate Analysis
  • Mediastinum