Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap

Cengiz Ovalı; Alper Selim Kocaoğlu; Merve Nur Güçlüer Kocaoğlu; Atacan Emre Koçman

Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap

Abstract

Introduction: Mediastinitis is a rare occurrence following cardiac surgeries; however, it is a significant cause of both mortality and morbidity. Given the significance of mediastinal infections, early diagnosis, and treatment become of paramount importance. The management of this condition necessitates a multidisciplinary approach, involving collaboration and coordination among various medical specialties. Patients and Methods: 21 patients with a diagnosis of deep mediastinal infection who were treated at Eskişehir Osmangazi University Medical Faculty Hospital between January 2015 and May 2021 were included in the study. Broad-spectrum antibiotic therapy, serial debridement, and vacuum-assisted closure were applied to all patients. Among the patients who exhibited negative blood cultures and developed granulation tissue, those with tissue losses that did not extend to the sternum incision sites were assessed for potential flap procedures in conjunction with plastic and reconstructive surgery. In such cases, closure of the wound was achieved using a pectoral muscle flap. All patients were followed for one year. Results: Among the patients, 14 (66.6%) were female and seven (33.3%) were male, with a mean age of 62.7 ± 6.5 (range: 41-76 years). Three of the 21 patients included in the study had type I, two had type II, and 16 had type IIIA mediastinitis. Staphylococcus aureus (S. aureus) was the most commonly isolated microorganism with 11 patients (52.3%). The right pectoralis major muscle was used in four patients (19%), the left pectoralis major muscle in four patients (19%), and the bilateral pectoralis major muscle in 13 patients (62%). There was no need for re-intervention in the follow-up of the patients. No mortality because of infection, surgical muscle flap closure, and/or cardiac causes was observed in any of the patients who were treated. Conclusion: Mediastinitis is a costly treatment, requiring prolonged hospitalization and carrying the risk of mortality. The main objective is to prevent the occurrence of mediastinitis. We believe that this objective should be pursued through a multidisciplinary approach involving cardiovascular surgery, infectious diseases, and plastic and reconstructive surgery units.

Keywords

References

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Details

Primary Language

English

Subjects

Cardiology

Journal Section

Research Article

Authors

Cengiz Ovalı ^* This is me
0000-0001-9371-8377
Türkiye

Alper Selim Kocaoğlu This is me
0000-0003-2245-3775
Türkiye

Merve Nur Güçlüer Kocaoğlu This is me
0009-0003-3452-1816
Türkiye

Atacan Emre Koçman This is me
0000-0001-8196-1142
Türkiye

Publication Date

July 12, 2023

Submission Date

May 5, 2023

Acceptance Date

June 13, 2023

Published in Issue

Year 2023 Volume: 26 Number: 2

IZ

https://izlik.org/JA73DY97XA

Cite

RIS / Bibtex

APA

Ovalı, C., Kocaoğlu, A. S., Güçlüer Kocaoğlu, M. N., & Koçman, A. E. (2023). Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap. Koşuyolu Heart Journal, 26(2), 88-95. https://izlik.org/JA73DY97XA

AMA

1.Ovalı C, Kocaoğlu AS, Güçlüer Kocaoğlu MN, Koçman AE. Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap. Koşuyolu Heart Journal. 2023;26(2):88-95. https://izlik.org/JA73DY97XA

Chicago

Ovalı, Cengiz, Alper Selim Kocaoğlu, Merve Nur Güçlüer Kocaoğlu, and Atacan Emre Koçman. 2023. “Treatment of Deep Mediastinal Infections Following Cardiac Surgery With Pectoral Muscle Flap”. Koşuyolu Heart Journal 26 (2): 88-95. https://izlik.org/JA73DY97XA.

EndNote

Ovalı C, Kocaoğlu AS, Güçlüer Kocaoğlu MN, Koçman AE (July 1, 2023) Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap. Koşuyolu Heart Journal 26 2 88–95.

IEEE

[1]C. Ovalı, A. S. Kocaoğlu, M. N. Güçlüer Kocaoğlu, and A. E. Koçman, “Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap”, Koşuyolu Heart Journal, vol. 26, no. 2, pp. 88–95, July 2023, [Online]. Available: https://izlik.org/JA73DY97XA

ISNAD

Ovalı, Cengiz - Kocaoğlu, Alper Selim - Güçlüer Kocaoğlu, Merve Nur - Koçman, Atacan Emre. “Treatment of Deep Mediastinal Infections Following Cardiac Surgery With Pectoral Muscle Flap”. Koşuyolu Heart Journal 26/2 (July 1, 2023): 88-95. https://izlik.org/JA73DY97XA.

JAMA

1.Ovalı C, Kocaoğlu AS, Güçlüer Kocaoğlu MN, Koçman AE. Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap. Koşuyolu Heart Journal. 2023;26:88–95.

MLA

Ovalı, Cengiz, et al. “Treatment of Deep Mediastinal Infections Following Cardiac Surgery With Pectoral Muscle Flap”. Koşuyolu Heart Journal, vol. 26, no. 2, July 2023, pp. 88-95, https://izlik.org/JA73DY97XA.

Vancouver

1.Cengiz Ovalı, Alper Selim Kocaoğlu, Merve Nur Güçlüer Kocaoğlu, Atacan Emre Koçman. Treatment of Deep Mediastinal Infections Following Cardiac Surgery with Pectoral Muscle Flap. Koşuyolu Heart Journal [Internet]. 2023 Jul. 1;26(2):88-95. Available from: https://izlik.org/JA73DY97XA