Ennker I C, Bär A K, Florath I, Ennker J, Vogt P M
MediClin Heart Institute Lahr/Baden, Lahr/Schwarzwald, Germany.
Thorac Cardiovasc Surg. 2011 Feb;59(1):15-20. doi: 10.1055/s-0030-1250335. Epub 2011 Jan 17.
Poststernotomy mediastinitis following median sternotomy procedures such as open heart surgery is a rare complication which nevertheless has a mortality rate of up to 50 %. Several treatment options are currently available; however, none of them are standardized. Based on the experience gained from open heart surgery performed at the MediClin Heart Institute Lahr/Baden, a therapeutic algorithm was developed. The treatment steps consist of repeated radical surgical debridement, sternal restabilization, vacuum-assisted closure therapy (VAC) as well as a surgical reconstruction via M. pectoralis plasty (MPP). This approach had a 30-day mortality of 0 % and a hospital mortality of 10.4 %. The approach proved to be safe and advantageous for specific patient groups operated on at the MediClin Heart Institute Lahr/Baden.
在诸如心脏直视手术等正中胸骨切开术之后发生的胸骨切开术后纵隔炎是一种罕见的并发症，但其死亡率高达50%。目前有几种治疗选择；然而，它们都没有标准化。基于在拉赫/巴登的梅迪克林心脏研究所进行心脏直视手术所获得的经验，制定了一种治疗算法。治疗步骤包括反复进行根治性手术清创、胸骨再稳定、负压封闭引流疗法（VAC）以及通过胸大肌成形术（MPP）进行手术重建。这种方法的30天死亡率为0%，医院死亡率为10.4%。对于在拉赫/巴登的梅迪克林心脏研究所接受手术的特定患者群体，该方法被证明是安全且有益的。
