Suzuki Kazuchika, Ishigami Naoyuki, Akuzawa Satoshi
Department of Cardiovascular Surgery, Fujieda Municipal General Hospital, Fujieda, Japan.
Kyobu Geka. 2018 Oct;71(11):916-918.
Mediastinitis occurs after open heart surgery in a small number of cases. When it occurs, early diagnosis and treatment are important. A 69-year-old male patient suffered from mediastinitis after total aortic arch replacement. He has cured completely by negative pressure wound therapy (NPWT) with irrigation method. The vacuum-assisted closure( VAC) method is very useful for wound repair and has recently been used to treat mediastinitis. However, the use of VAC alone does not always result in complete cure. NPWT with irrigation is a very useful infection control method. Performing NPWT before VAC might contribute to improving the outcomes of mediastinitis treatment. However, it is difficult to decide when to switch from NPWT with irrigation to VAC.
少数情况下，纵隔炎会在心脏直视手术后发生。一旦发生，早期诊断和治疗至关重要。一名69岁男性患者在全主动脉弓置换术后患上纵隔炎。通过负压伤口治疗（NPWT）冲洗法，他已完全治愈。真空辅助闭合（VAC）法对伤口修复非常有用，最近已被用于治疗纵隔炎。然而，单独使用VAC并不总能完全治愈。NPWT冲洗法是一种非常有用的感染控制方法。在VAC之前进行NPWT可能有助于改善纵隔炎的治疗效果。然而，很难决定何时从NPWT冲洗法转换为VAC。
