Asano S, Murayama H, Ishida A, Nakagawa Y, Ito M, Sudo Y
Department of Cardiovascular Surgery, Tsurumai Hospital, Ichihara, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1996 Jun;44(6):814-9.
A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm. Two weeks after the surgery, high fever and leucocytosis developed. He was placed on a regimen of antibiotics. However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound. The culture revealed a Methicillin resistant staphylococcus aureus. The infected tissue was debrided from the mediastinal cavity 40 days postoperatively. The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days. Subsequently, an omental graft was placed. The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery. The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis.
一名78岁男性因主动脉弓动脉瘤破裂接受了全主动脉弓置换术。术后两周，出现高热和白细胞增多。他接受了抗生素治疗。然而，五周后最终发生了纵隔炎，有脓液从胸骨切开伤口流出。培养显示为耐甲氧西林金黄色葡萄球菌。术后40天从纵隔腔清除感染组织。让腔保持开放，用2%聚维酮碘间歇冲洗三天。随后，放置了大网膜移植物。感染逐渐成功消退，患者在初次手术后一年半情况良好。该手术被认为对涉及胸主动脉假体的严重感染的处理极为有效。
