Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant

Postoperative sternal dehiscence is a severe complication of cardiac surgery. The aim of the study was to evaluate the outcomes of different surgical treatment tactics in patients with postoperative sternal mediastinitis. A total of 41 patients with postoperative sternal mediastinitis were studied f...

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Autores principales:	M. V. Shvedova, G. T. Dambaev, A. N. Vusik
Formato:	article
Lenguaje:	RU
Publicado:	Scientific Сentre for Family Health and Human Reproduction Problems 2015
Materias:	postoperative sternal mediastinitis sternum resynthesis titanium nickelide poromeric mesh implant Science Q
Acceso en línea:	https://doaj.org/article/ef0f1c280fa8480584fda8ff438cbc14
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spelling	oai:doaj.org-article:ef0f1c280fa8480584fda8ff438cbc142021-11-23T06:14:32ZSurgical treatment of postoperative sternal mediastinitis using titanium nickelide implant2541-94202587-9596https://doaj.org/article/ef0f1c280fa8480584fda8ff438cbc142015-04-01T00:00:00Zhttps://www.actabiomedica.ru/jour/article/view/28https://doaj.org/toc/2541-9420https://doaj.org/toc/2587-9596Postoperative sternal dehiscence is a severe complication of cardiac surgery. The aim of the study was to evaluate the outcomes of different surgical treatment tactics in patients with postoperative sternal mediastinitis. A total of 41 patients with postoperative sternal mediastinitis were studied from 2010 to 2014. Patients comprised 29 men (70,7%) and 12 women (29,3%) aged 61,12 ± 8,62 years. The first stage of surgical intervention included: secondary surgical debridement; surgical debridement with metal osteosynthesis (MOS) by metal suture (configurations: 1-1-1-1-1-1; 1-Х-1-1-1-1; 1-8-8-8) and longitudinal MOS of the left middle third of the sternum + transverse MOS (configurations: Z-Z-Z and 1-1-88-1-1 among others); sternal resynthesis with mesh titanium nickelide implant according to originally designed method (patent of the Russian Federation N 2489097). The study demonstrated that routine sternoraphy is not recommended in patients who underwent operations involving median sternotomy or if the re-thoracotomy is required due to infection complication in the sternum and anterior mediastinum. Indeed, this method did not result in recovery in 72,22% of cases and even worsened sternal fragmentation. In case of the absence of severe sternal fragmentation and when elimination of acute inflammation was achieved (surgical debridement, correct antibiotic therapy, and bandaging), sternal resynthesis with mesh titanium nickelide implant was preferable. Combination of this method with surgical debridement of the sternum and anterior mediastinum was acceptable in patients with chronic sternal osteomyelitis and mediastinitis. The method of sternal resynthesis with mesh titanium nickelide implant achieved good immediate results and secure fixation of the sternal fragments with recovery of sternal continuity. This method should be indicatedfor treatment of patients without severe sternal fragmentation.M. V. ShvedovaG. T. DambaevA. N. VusikScientific Сentre for Family Health and Human Reproduction Problemsarticlepostoperative sternal mediastinitissternum resynthesistitanium nickelideporomeric mesh implantScienceQRUActa Biomedica Scientifica, Vol 0, Iss 2, Pp 42-45 (2015)
institution	DOAJ
collection	DOAJ
language	RU
topic	postoperative sternal mediastinitis sternum resynthesis titanium nickelide poromeric mesh implant Science Q
spellingShingle	postoperative sternal mediastinitis sternum resynthesis titanium nickelide poromeric mesh implant Science Q M. V. Shvedova G. T. Dambaev A. N. Vusik Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
description	Postoperative sternal dehiscence is a severe complication of cardiac surgery. The aim of the study was to evaluate the outcomes of different surgical treatment tactics in patients with postoperative sternal mediastinitis. A total of 41 patients with postoperative sternal mediastinitis were studied from 2010 to 2014. Patients comprised 29 men (70,7%) and 12 women (29,3%) aged 61,12 ± 8,62 years. The first stage of surgical intervention included: secondary surgical debridement; surgical debridement with metal osteosynthesis (MOS) by metal suture (configurations: 1-1-1-1-1-1; 1-Х-1-1-1-1; 1-8-8-8) and longitudinal MOS of the left middle third of the sternum + transverse MOS (configurations: Z-Z-Z and 1-1-88-1-1 among others); sternal resynthesis with mesh titanium nickelide implant according to originally designed method (patent of the Russian Federation N 2489097). The study demonstrated that routine sternoraphy is not recommended in patients who underwent operations involving median sternotomy or if the re-thoracotomy is required due to infection complication in the sternum and anterior mediastinum. Indeed, this method did not result in recovery in 72,22% of cases and even worsened sternal fragmentation. In case of the absence of severe sternal fragmentation and when elimination of acute inflammation was achieved (surgical debridement, correct antibiotic therapy, and bandaging), sternal resynthesis with mesh titanium nickelide implant was preferable. Combination of this method with surgical debridement of the sternum and anterior mediastinum was acceptable in patients with chronic sternal osteomyelitis and mediastinitis. The method of sternal resynthesis with mesh titanium nickelide implant achieved good immediate results and secure fixation of the sternal fragments with recovery of sternal continuity. This method should be indicatedfor treatment of patients without severe sternal fragmentation.
format	article
author	M. V. Shvedova G. T. Dambaev A. N. Vusik
author_facet	M. V. Shvedova G. T. Dambaev A. N. Vusik
author_sort	M. V. Shvedova
title	Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
title_short	Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
title_full	Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
title_fullStr	Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
title_full_unstemmed	Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
title_sort	surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant
publisher	Scientific Сentre for Family Health and Human Reproduction Problems
publishDate	2015
url	https://doaj.org/article/ef0f1c280fa8480584fda8ff438cbc14
work_keys_str_mv	AT mvshvedova surgicaltreatmentofpostoperativesternalmediastinitisusingtitaniumnickelideimplant AT gtdambaev surgicaltreatmentofpostoperativesternalmediastinitisusingtitaniumnickelideimplant AT anvusik surgicaltreatmentofpostoperativesternalmediastinitisusingtitaniumnickelideimplant
_version_	1718417106790252544

Surgical treatment of postoperative sternal mediastinitis using titanium nickelide implant

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