Infants diagnosed with cardiac post-surgery mediastinitis within the HUDERF Hospital within the last 20 years.

Adults diagnosed with cardiac post-surgery mediastinitis within the CHU Brugmann Hospital within the last 20 years.

Mediastinitis

Data extraction from medical files

CHU Brugmann

Post-Surgical Mediastinitis Within the CHU Brugmann Hospital

Post-Surgical Mediastinitis: Retrospective Study of Cases Treated Within the CHU Brugmann Hospital

Mortality rate six months after mediastinitis diagnosis

Percentage of recurrence of mediastinitis

Percentage of re-hospitalizations caused by mediastinitis

Duration of the antibiotic treatment for mediastinitis

Demographic data : presence of risk factors (obesity, diabetes...).

Name of the surgical intervention that caused the mediastinitis

Name of the germ causing the mediastinitis

Name of the antibiotics used to treat the mediastinitis

Pierre Wauthy

Medical Director of the Hospital

after the diagnosis of the poststernotomy wound infection is established the clinical procedure is obtained as follows: firstly the empiric antibiotic therapy with vancomycin is induced. The lab samples including bacteriology test are obtained. Surgical debridement is made until occurrence of tissue bleeding. Finally VAC sponge is implanted wit the negative suction pressure of 75 mmHg.
The patients are obtained 5 to 7 times to the surgical procedures in time intervals of 48/72 hours. Subsequently when the last three bacteriology samples are negative a delayed primary closure or rectus abdominal muscle flap may be done.

In the first step, after the diagnosis of the infection was done, and the empiric antibiotic therapy is induced with vancomycin in the first surgical intervention the sternal wires will be removed, the mediastinum is explored and extensive surgical debridement is performed until occurrence of tissue bleeding.The patients will receive treatment delivered through the VAC system in the first 48 hours following the first surgical intervention, subsequently the wound is closed.

Arm A) Secondary closure with the vacuum-assisted system (VAC); The initial surgical revision is done within 24 hours. The first revision with second look and debridement is usually made in 72 hours Subsequently in the following days the wound is stepwise revised during VAC changes.The patients are obtained 5 to 7 times to the surgical procedures in time intervals of 72 hours. Subsequently when the last three bacteriology samples are negative a delayed primary closure or rectus abdominal muscle flap may be done.
Arm B) Surgical procedure by delayed primary closure; The patients will receive treatment delivered through the VAC system in the first 48 hours following the first surgical intervention, subsequently the wound is closed. after the sternum is closed by using metallic wires, pectoral muscle on both chest parts is mobilized and closed directly over the bone.

Surgical closure of the poststernotomy wound infection

Departement of Cardiovascular Surgery, University Hospital Lausanne (CHUV)

Delayed Primary Versus Late Secondary Wound Closure in Sternum Infections

Delayed Primary Versus Late Secondary Wound Closure in the Treatment of Postsurgical Sternum Osteomyelitis

Denis Berdajs

University of Lausanne Hospitals

University Hospital Olomouc

The patient population for this study consists of all patients undergoing cardiac surgical interventions. All patients who meet the eligibility criteria may be included in the study regardless of gender, race or ethnicity.

mediastinitis/השמנת יתר חולנית

Post-Surgical Mediastinitis Within the CHU Brugmann Hospital

Delayed Primary Versus Late Secondary Wound Closure in Sternum Infections

Management Practices and the Risk of Infection Following Cardiac Surgery

המאגר השלם ביותר של צמחי מרפא המגובה על ידי המדע