Shiraishi Y, Miyamoto T, Shimada I, Pak C, Enomoto S, Shinkura N, Ohno N, Nishina K, Oda T, Takeuchi T
Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1991 Dec;39(12):2152-6.
From January, 1986 to May, 1990 twenty one adult patients (men 16, women 5, age 64 +/- 7 years old) underwent transposition of the greater omentum to control mediastinal infection after coronary artery bypass surgery. Upon diagnosing mediastinitis, the mediastinum was drained open and irrigated with 0.5% povidone iodine-saline solution until the omental transposition. The interval between the diagnosis of mediastinitis and the omental transposition ranged from 0 to 171 (mean 19) days. Three quarters of the patients had the omentum transposed within 14 days. In nineteen of 21 patients (90%) the mediastinitis was effectively controlled. In the remaining two patients the infection could not be controlled and proceeded to succumb from multiple organ failure. There was no complication related to the omental transposition in itself. We conclude that transposition of the greater omentum is a safe and effective method for treating mediastinal infection after coronary artery bypass surgery.
1986年1月至1990年5月,21例成年患者(男性16例,女性5例,年龄64±7岁)在冠状动脉搭桥手术后接受了大网膜移位术以控制纵隔感染。诊断为纵隔炎后,打开纵隔引流,并用0.5%聚维酮碘盐水溶液冲洗,直至进行大网膜移位术。纵隔炎诊断与大网膜移位术之间的间隔时间为0至171天(平均19天)。四分之三的患者在14天内进行了大网膜移位。21例患者中有19例(90%)纵隔炎得到有效控制。其余2例患者感染未能得到控制,最终死于多器官功能衰竭。大网膜移位术本身未发生并发症。我们得出结论,大网膜移位术是治疗冠状动脉搭桥手术后纵隔感染的一种安全有效的方法。