Mediastinitis Clinical Trial
Official title:
Post-Surgical Mediastinitis: Retrospective Study of Cases Treated Within the CHU Brugmann Hospital
Mediastinitis is an infectious complication that can occur after cardiac surgery. The
incidence varies between 1 and 3% depending on the type of procedure and the patient's
condition. The mortality of this severe postoperative complication rises from 10 to 35%,
which makes it dreadful.
The major risk factors reported are obesity, diabetes, and immunosuppressive therapy. There
are other less important ones: age, coronary bypass grafting (especially if using the two
internal mammary arteries), nosocomial pneumonia, dialysis, prolonged mechanical ventilation,
long operative asepsis, undrained retro-sternally hematoma, prolonged pre-operative
hospitalization...).
Prevention is very important. The principle of asepsis must absolutely be respected. The use
of prophylactic antibiotic therapy is recommended.
The most commonly encountered organisms are Staphylococcus aureus, coagulase-negative
Staphylococci and gram-negative bacilli.
There are several treatment modalities that vary between centers and may be different
depending on the surgical team's experience and the depth or extent of the infection. The
common principles of these treatments are: antibiotic therapy and surgical debridement (the
timing of which may vary). The timing and modalities of wound closure are subject to
variations: immediate sternal closure with placement of multiple or delayed drains. Muscle
flaps or large omentum transplant may be necessary if tissue loss is too important.
The investigators propose to review their experience in the treatment of cardiac post-surgery
mediastinitis at Brugmann University Hospital in the last 20 years in both adult and
pediatric patients.
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