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)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/238832
- author
- Sjögren, Johan
LU
; Gustafsson, Ronny
LU
; Nilsson, Johan
LU
; Malmsjö, Malin
LU
and Ingemansson, Richard
LU
- organization
- publishing date
- 2005
- 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
- 2016-04-01 12:38:48
- date last changed
- 2024-10-09 17:53:13
@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 < 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.}},
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}},
doi = {{10.1016/j.athoracsur.2004.12.048}},
volume = {{79}},
year = {{2005}},
}