NEGATIVE PRESSURE IN THE TREATMENT OF WOUND INFECTIOUS COMPLICATIONS IN THE TREATMENT OF STERNO-MEDIASTINITIS AFTER CARDIAC SURGERY IN CHILDREN UNDER 1 YEAR



如何引用文章

全文:

详细

Aim of the study. To evaluate the results of treatment of sterno- mediastinitis using vacuum therapy in patients of the first year of life. Material and methods. The study included 25 children under the age of 1 year who had undergone cardiac surgery from median sternotomy in the period from August 2013 to August 2016 on the basis of the E.N. Meshalkin National Medical Research Center, , complicated by infection of the wound. Results. Vacuum therapy in the treatment of sterno-mediastinitis was used in 25 infants, aged 103 (average) (9 ÷ 167) days. Superficial infection developed in 10 (40%) patients, deep infection - in 15 (60%) children. The average duration of vacuum therapy was 6.9 (3 ÷ 8) days. The average time of artificial lung ventilation was 147 (12 ÷ 176) hours, the duration of treatment in the intensive care unit was 7.6 (3.2 ÷ 8.6) days. Complications were present in 7 (28%) patients and included multiple organ failure (8%), isolated renal dysfunction (12%), bleeding (4%), relapse of infection (4%). 2 (8%) patients died due to symptoms of severe multiorgan failure. The average length of the hospital stay was of 30 (23 ÷ 38) days. Conclusions. Vacuum therapy can be successfully used for the treatment of sterno-mediastinitis in children of the first year of life as also an excellent alternative to the traditional treatment method.

作者简介

S. Ivantsov

E.N. Meshalkin National Medical Research Center

编辑信件的主要联系方式.
Email: noemail@neicon.ru
俄罗斯联邦

I. Soinov

E.N. Meshalkin National Medical Research Center

Email: i_soynov@mail.ru
俄罗斯联邦

Yu. Kulyabin

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

N. Nichay

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

A. Voitov

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

A. Gorbatykh

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

A. Zubritsky

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

Yu. Gorbatykh

E.N. Meshalkin National Medical Research Center

Email: noemail@neicon.ru
俄罗斯联邦

参考

  1. Fleck T., Simon P., Burda G., Wolner E., Wollenek G. Vacuum assisted closure therapy for the treatment of sternal wound infections in neonates and small infants. Interact CardioVascThorac Surg. 2006; 5 (3): 285-8. doi: 10.1510/icvts.2005.122424
  2. Filippelli S., Perri G., Brancaccio G., Iodice F.G., Albanese S.B., Trimarchi E., Carotti A. Vacuum-assisted closure system in newborns after cardiac surgery. J Card Surg. 2015 Feb;30(2):190-3. doi: 10.1111/jocs.12463
  3. Рузматов Т.М., Эфендиев В.У., Бобошко А. В., Малахов Е.С., Несмачный А.С., Разумахин Р.А., Карева Ю.Е., Чернявский А.М. Вакуумная терапия послеоперационного стерномедиастенита. Хирургия. 2015; 8: 14-8. doi: 10.17116/hirurgia2015814-17
  4. Иванцов С.М., Сойнов И.А., Омельченко А. Ю., Ничай Н. Р., Кулябин Ю. Ю., Горбатых А. В., Войтов А. В., Горбатых Ю.Н. VAC-терапия: новый метод лечение медиастинитов у новорожденных детей. Медицинский альманах. 2016 2 102-4.doi: http://dx.doi.org/10.21145/2499-9954-2016-2-102-104
  5. Levy I, Ovadia B, Erez E, Rinat S, Ashkenazi S, Birk E, Konisberger H, Vidne B, Dagan O. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J. HospInf 2003;53:111-6. doi: http://dx.doi.org/10.1053/jhin.2002.1359
  6. Erez E, Katz M, Sharoni E, et.al. Pectoralis major muscle flap for deep sternal wound infection in neonates. Ann Thorac Surg 2000;69:572-7.doi: http://dx.doi.org/10.1016/S0003-4975(99)01075-9
  7. Mehta PA, Cunningham CK, Colella CB, Alferis G, Weiner LB. Risk factors for sternal wound and other infections in pediatric cardiac surgery patients. Pediatr Infect Dis. J. 2000;19:1000-4.doi: http://dx.doi.org/10.1016/S0003-4975(03)01025-7
  8. Tortoriello TA, Friedman JD, McKenzie D,et.al. Mediastinitis after pediatric cardiac surgery: a 15-year experience at a single institution. Ann Thorac Surg 2003;76:1655-60.doi: http://dx.doi.org/10.1016/S0003-4975(03)01025-7
  9. Argenta L.C., Morykwas M.J. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997 Jun;38(6):563-76. doi: 10.1201/b17524-48
  10. Jenkins K.J., Gauvreau K. Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method. J. ThoracCardiovasc Surg. 2002 Jul;124(1):97-104.doi: http://dx.doi.org/10.1067/mtc.2002.122311
  11. Vida V.L., Leon-Wyss J., Larrazabal A., Cruz S., Castaneda A.R. Mediastinitis in pediatric cardiac surgery: treatment and cost-effectiveness in a low-income country. Pediatr. Cardiol. 2007 May-Jun;28(3):163-6.doi: 10.1007/s00246-006-0008-1
  12. Caniano DA, Ruth B, Teich S. Wound management with vacuum assisted closure: experience in 52 pediatric patients. J. Ped Surg 2005;40:128-32.doi: 10.1016/j.jpedsurg.2004.09.016
  13. Kornilov I.A., Ponomarev D.N., Sinelnikov Y.S., Soinov I.A., Kshanovskaya M.S., Gorbatykh A.V., Omelchenko A.Y., Krivoshapkina A.A. Outcomes after aortic arch reconstruction for infants: deep hypothermic circulatory arrest versus moderate hypothermia with selective antegrade cerebral perfusion. European Journal of Cardio-Thoracic Surgery. 2015; 48( 3): e45-50.doi: 10.1093/ejcts/ezv235
  14. Корнилов И.А., Синельников Ю.С., Сойнов И.А., Кшановская М.С., Пономарёв Д.Н., Матюшов В.Н., Горбатых А.В., Горбатых Ю.Н. Оценка риска почечных и неврологических осложнений у новорожденных детей после реконструкции аорты. Патология кровообращения и кардиохирургия. 2015; 19 (1): 84-9.doi: http://dx.doi.org/10.21688/1681-3472-2015-1-84-89
  15. Gustafsson, R.I., Sjogren, J., Ingemansson, R. Deep sternal wound infection (a sternal-sparing technique with vacuum-assisted closure therapy). Ann Thorac Surg. 2003;76:2048-53.doi: http://dx.doi.org/10.1016/S0003-4975(03)01337-7

补充文件

附件文件
动作
1. JATS XML

版权所有 © , 2019

##common.cookie##