Kuraoka S, Watanabe T, Inui K, Minowa T, Oshikiri N, Hosaka J, Takeda H, Shimazaki Y
Second Department of Surgery, Yamagata University School of Medicine, Japan.
Kyobu Geka. 1999 Mar;52(3):218-23.
Between 1978 and 1997, 9 patients developed poststernotomy mediastinitis after coronary artery bypass grafting. Four of these patients (group A) were treated with open drainage and mediastinal irrigation or omental transfer. The other 5 patients (group B) were treated with primary wound closure by the technique of muscle flap mobilization. The purpose of this study was to compare the surgical results and graft patency of both groups. The hospital mortality of group A was 100 per cent. All patients in group B survived for 35 months of the mean postoperative periods without complaints. Postoperative coronary angiography revealed the complete graft patency in group B. We conclude that muscle flap mobilization may be a superior measure for the patient survival and graft patency as the treatment of mediastinitis after coronary artery bypass grafting.