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Titolo:
Fewer reoperations and shorter stay in the cardiac surgical ward when stabilising the sternum with the Ley prosthesis in post-operative mediastinitis
Autore:
Astudillo, R; Vaage, J; Myhre, U; Karevold, A; Gardlund, B;
Indirizzi:
Univ Trondheim Hosp, Dept Cardiothorac Surg, St Elisabeth Heart Ctr, N-7018 Trondheim, Norway Univ Trondheim Hosp Trondheim Norway N-7018 tr, N-7018 Trondheim, Norway Karolinska Hosp, Dept Cardiothorac Surg, S-10401 Stockholm, Sweden Karolinska Hosp Stockholm Sweden S-10401 Surg, S-10401 Stockholm, Sweden Karolinska Hosp, Dept Infect Dis, S-10401 Stockholm, Sweden Karolinska Hosp Stockholm Sweden S-10401 Dis, S-10401 Stockholm, Sweden
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 1, volume: 20, anno: 2001,
pagine: 133 - 139
SICI:
1010-7940(200107)20:1<133:FRASSI>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
RISK-FACTORS; SURGERY; BYPASS; COMPLICATIONS; MANAGEMENT;
Keywords:
heart surgery; sternal dehiscence; sternotomy; mediastinitis; hospital stay; reoperations;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Astudillo, R Univ Trondheim Hosp, Dept Cardiothorac Surg, St Elisabeth Heart Ctr, Hans Nissens Gate 3, N-7018 Trondheim, Norway Univ Trondheim Hosp Hans Nissens Gate 3 Trondheim Norway N-7018
Citazione:
R. Astudillo et al., "Fewer reoperations and shorter stay in the cardiac surgical ward when stabilising the sternum with the Ley prosthesis in post-operative mediastinitis", EUR J CAR-T, 20(1), 2001, pp. 133-139

Abstract

Objective: Using the Ley prosthesis, a 0.5 mm thick titanium alloy plate for stabilising the sternum, is a new method in the treatment of mediastinitis after open-heart surgery. We report a retrospective analysis of our experience with this device. Methods: One hundred consecutive cases of post-operative mediastinitis in the period 1992-1997 were reviewed. The primary procedure at reoperation for infection was as follows: 52 patients were treated with the Ley prosthesis and 48 patients underwent other conventional procedures. The choice of the surgical technique depended on the attending surgeon. The prosthesis was used more frequently in patients with sternal dehiscence (P < 0.001) but otherwise patients' characteristics were similar in the two groups. As a control population for outcome data, 100 uninfected patients were matched with regard to operative procedure, age, sex and date ofsurgery. Results: The median hospital stay was 48.5 days in the mediastinitis group vs. 14 days in the control group. The all-cause 90-day mortality in the mediastinitis group was 18% vs. 5% in the control group. The 52 patients treated with the Ley prosthesis had a median length of stay in the cardiac surgery ward for 29 days vs. 41.5 days in the mediastinitis group not treated with the prosthesis (P = 0.013). However, when the total length of stay including hospitals outside the cardiac surgery ward was taken into account, the prosthesis did not reduce the length of stay. Only 8/52 patientstreated with the prosthesis required further surgery vs. 23/48 patients who were not primarily treated with the prosthesis (P < 0.001). The Ley prosthesis had no impact on mortality. Conclusion: The Ley prosthesis is a valuable adjunct to the treatment of mediastinitis after open-heart surgery. A shorter stay at the cardiac surgery ward and a reduced need for Further surgical procedures were observed when using this prosthesis. (C) 2001 ElsevierScience B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 08:34:47