AN APPROACH FOR MEDIASTINITIS PREVENTIONIN PATIENTS FOLLOWING CARDIAC SURGERY



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Abstract

The aim of this study was to reduce incidence of sternal deep wound infection (DWI) in patients following cardiac surgery. An experience of cardiac surgery by sternotomy access in 429 consecutive patients was presented. Perioperative intravenous injections of cefazolin were used in 225 patients (control group). Combination of perioperative intravenous injections with local retrosternal irrigation of cefazolin before sternum closure was used in 204 patients (study group). In control group sternal DWI occurred in 10 patients (4.4%), and in 4 patients a resternotomy sanation required. There were no deaths in this group due to infection or sepsis. In follow-up period (3 years), instability of sternum occurred in 3 patients (1.3%), and in 1 (0.4%) sternum reosteosynthesis required. In studied group the sternal DWI did not occur (p<0.01). Sternum instability and/or indications for sternum reosteosynthesis were not determined in follow-up period (2 years). It was concluded, that combination of intravenous and local usage of cefazolin in cardiac surgery patients is a simple and effective approach to prevent sternal DWI. Application of this method significantly (p<0.01) reduces the incidence rate of mediastinitis.

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About the authors

A V Sotnikov

North-Western State Medical University named after I.I. Mechnikov

V M Melnikov

North-Western State Medical University named after I.I. Mechnikov

R V Almadi

North-Western State Medical University named after I.I. Mechnikov

G N Gorbunov

North-Western State Medical University named after I.I. Mechnikov

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Copyright (c) 2015 Sotnikov A.V., Melnikov V.M., Almadi R.V., Gorbunov G.N.

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