Please review the following:

Early Repair of Sternal Instability Prevents Mediastinitis. World Journal of Cardiovascular Surgery 2014, 4, 13-16

 Koray Aykut1*, Gokhan Albayrak1, Aycan Kavala2, Mehmet Guzeloglu1, Kemal Karaarslan3, Eyup Hazan1

ABSTRACT Background: Discharge due to superficial wound infection and sternal dehiscence are the common complications of median sternotomy. This condition leads to mediastinitis. Mediastinitis is a serious condition which increases morbidity, mortality and hospital costs. The correct time for surgical treatment is contraversial in cases who have sternal dehiscence and discharge due to superficial infection. In this study, patients received sternal stabilization as soon as a diagnosis was made and monitored for the development of mediastinitis. Methods: Among the 1440 patients who had undergone elective CABG, a total of 85 patients who developed sternal dehiscence and superficial wound discharge were included in this study. These patients were re-operated on as soon as diagnosed and early sternal stabilization was provided. Results: The ratio of overall dehiscence was 5.9%. Mediastinitis developed in only 2 of the 85 patients. These patients were treated with VAC (Vacuum Assisted Closure) therapy. The ratio of overall mediastinitis was 0.13. Mediastinitis-related mortality was not detected. Conclusion: The ratio of mediastinitis decreases when patients who have discharge due to sternal dehiscence and superficial wound infection are immediately reviewed without waiting for the results of conventional methods such as antibiotic treatment and chest binder support.

Sternum support vests to prevent sternal dehiscence

www.health.qld.gov.au/healthpact/docs/.../WP160.pdfCached

Early and late sternal wound infections following open heart surgery

Steinn Steingrímsson skemman.is/stream/get/1946/.../Steinn_Steingrimsson_b5_Skemman.pdfCached

Similar

Take a look at the abstracts the following link

Journal of Cardiothoracic Surgery

2013, Volume 8 Suppl 1

http://www.cardiothoracicsurgery.org/supplements/8/S1

thank you very much

De acuerdo completo con Amar Safdar y con el titulo del trabajo que recomienda.

Saludos a los dos profesionales.

Thank you very much dr Canto, wouild you please rewrite it in english

Im totally agree with amar safdar and with the title of the work that recomended.

Kind regards,

Dr.Cantó.

I agree with the above. We have reduced sternum infections rate/mediastinits in our department to 1,3 % during the last 12 years. We apply Sternum Vest/ Chest binder support to all patients over 85 Kg, BMI> 35, konfus patients in 6-8 weeks. I highly recommend Thorax support.

Best wishes,

Dr. Khalil Ahmad

Referencer

1. Brocki, B. Thorup, C: "Postoperativ mobilisering af patienter med fuld sternotomi" Rapport. Specialkirurgisk Center. Aalborg Sygehus, Århus universitetshospital.

2. Meusler, Peg. "The sternum support harness for the treatment of sternotomy pain and the prevention of sternum instability". Cardiopulmonary Physical Therapy (2000) Vol. 11, NO. 2; 63-68.

3. Mcgregor, Walter E, trumble, Dennis R. Magovern, James A. "Mechanical analysis of midline sternotomy wound closure" The Journal of Thoracic and Cardiovascular Surgery, June 1999.

4. Adams, J. Cline, M.J. Hubbard, Matt, Mccullough, T: "A new paradigm for post-cardic event resistance exercise guidelines" Am J Cardiol 2006;97:281-286.

5. Brocki, B. Thorup, C: "Precautions related to midline sternotomy in cardiac surgery. A review of mechanical stress factors leading to sternal complications" nov. 2009.