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心外科胸骨切开术后纵隔炎的治疗及胸部重建:来自圣保罗大学医学院附属医院心脏研究所的报告

Treatment and Chest Reconstruction for Mediastinitis Following Sternotomy for Cardiac Surgery at the Heart Institute of the University of São Paulo Medical School.

机构信息

Plastic Surgery Division, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

Cardiothoracic Surgery Department, Universidade de São Paulo, São Paulo, São Paulo, Brazil.

出版信息

Braz J Cardiovasc Surg. 2021 Aug 6;36(4):565-570. doi: 10.21470/1678-9741-2020-0117.

Abstract

This study presents the method used for chest reconstruction and treatment of mediastinitis following cardiac surgery at the Heart Institute of the University of São Paulo Medical School. After infection control with antibiotic therapy associated with aggressive surgical debridement and negative pressure wound therapy, chest reconstruction is performed using flaps. The advantages and disadvantages of negative pressure wound therapy are discussed, as well as options for flap-based chest reconstruction according to the characteristics of the patient and sternum. Further studies are needed to provide evidence to support the decisions when facing this great challenge.

摘要

本研究介绍了圣保罗大学医学院心脏病研究所心脏手术后胸部重建和治疗纵隔炎的方法。在使用抗生素治疗控制感染并进行积极的清创和负压伤口治疗后,使用皮瓣进行胸部重建。讨论了负压伤口治疗的优缺点,以及根据患者和胸骨的特点选择基于皮瓣的胸部重建的方案。需要进一步的研究提供证据,以支持在面临这一巨大挑战时的决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9889/8522307/386e5c845410/rbccv-36-04-0565-g01.jpg

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