개심술후 발생한 종격동염의 치료

Abstract

Between January 1984 and January 1994, 13 patients developed mediastinitis after cardiac operations. There were 7 women and 6 men with a mean age of 24.2 years[range 0.7 - 61 . Initial operation included 7 valve replacements and 6 congenital cardiac repairs. The duration between initial operation and diagnosis was 13.5 days[range 4-57 . Organisms cultured from debridement material included S.aurus[n=9 , S.epidermidis[n=3 and Enterobacter[n=1 . Fever was the most frequent complaint and purulent drainage was noticed in 9 patients[69% . Seven patients were treated with radical debridement followed by closed irrigation. In other 6 patients, the wounds were managed by debridement, open granulation and delayed wound closure. Two hospital deaths [15.4% following open granulation method, resulted from sepsis. The 11 survivors were followed-up for 1-120 months, averaging 42 months and had healed wounds. One late death occurred due to massive hemorrhage.