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Clinical outcome after poststernotomy mediastinitis: Vacuum-assisted closure versus conventional treatment

Sjögren, Johan LU ; Gustafsson, Ronny LU ; Nilsson, Johan LU ; Malmsjö, Malin LU and Ingemansson, Richard LU (2005) In Annals of Thoracic Surgery 79(6). p.2049-2055
Abstract
Background. The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. Methods. One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April... (More)
Background. The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. Methods. One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April 2004 and was 100% complete. Actuarial statistics were used to calculate the survival rates. Results. The 90-days mortality was 0% in the vacuum-assisted closure group and 15% in the conventional treatment group (p < 0.01). The failure rate to first-line treatment with vacuum-assisted closure and conventional treatment were 0% and 37.5%, respectively (p < 0.001). There was no statistically significant difference in the recurrence of sternal fistulas after vacuum-assisted closure therapy or conventional treatment: 6.6% versus 5.0%, respectively. Overall survival in the vacuum-assisted closure group was significantly better (p < 0.05) than in the conventional treatment group: 97% versus 84% (6 months), 93% versus 82% (1 year), and 83% versus 59% (5 years). Conclusions. Our findings support that vacuum-assisted closure therapy is a safe and reliable option in poststernotomy mediastinitis with excellent survival and a very low failure rate compared with conventional treatment. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Thoracic Surgery
volume
79
issue
6
pages
2049 - 2055
publisher
Elsevier
external identifiers
  • wos:000229521100036
  • scopus:20444382047
ISSN
1552-6259
DOI
10.1016/j.athoracsur.2004.12.048
language
English
LU publication?
yes
id
4946e380-656e-48dc-bf6e-4c98392abbac (old id 238832)
date added to LUP
2007-08-08 09:06:28
date last changed
2017-11-05 03:49:59
@article{4946e380-656e-48dc-bf6e-4c98392abbac,
  abstract     = {Background. The conventional treatment for poststernotomy mediastinitis usually involves surgical revision, closed irrigation, or reconstruction with omentum or pectoral muscle flaps. Recently, vacuum-assisted closure has been successfully used in poststernotomy mediastinitis. The aim of the present study was to compare the clinical outcome and survival in 101 patients undergoing vacuum-assisted closure therapy or conventional treatment for poststernotomy mediastinitis. Methods. One hundred one consecutive patients underwent treatment for poststernotomy mediastinitis: vacuum-assisted closure therapy (January 1999 through December 2003, n = 61) or conventional treatment (July 1994 through December 1998, n = 40). Follow-up was made in April 2004 and was 100% complete. Actuarial statistics were used to calculate the survival rates. Results. The 90-days mortality was 0% in the vacuum-assisted closure group and 15% in the conventional treatment group (p &lt; 0.01). The failure rate to first-line treatment with vacuum-assisted closure and conventional treatment were 0% and 37.5%, respectively (p &lt; 0.001). There was no statistically significant difference in the recurrence of sternal fistulas after vacuum-assisted closure therapy or conventional treatment: 6.6% versus 5.0%, respectively. Overall survival in the vacuum-assisted closure group was significantly better (p &lt; 0.05) than in the conventional treatment group: 97% versus 84% (6 months), 93% versus 82% (1 year), and 83% versus 59% (5 years). Conclusions. Our findings support that vacuum-assisted closure therapy is a safe and reliable option in poststernotomy mediastinitis with excellent survival and a very low failure rate compared with conventional treatment.},
  author       = {Sjögren, Johan and Gustafsson, Ronny and Nilsson, Johan and Malmsjö, Malin and Ingemansson, Richard},
  issn         = {1552-6259},
  language     = {eng},
  number       = {6},
  pages        = {2049--2055},
  publisher    = {Elsevier},
  series       = {Annals of Thoracic Surgery},
  title        = {Clinical outcome after poststernotomy mediastinitis: Vacuum-assisted closure versus conventional treatment},
  url          = {http://dx.doi.org/10.1016/j.athoracsur.2004.12.048},
  volume       = {79},
  year         = {2005},
}