Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection
After cardiac surgery, healing can be delayed by sternal wound infection, particularly if mediastinitis develops. Because of the technical simplicity of omentopexy, we recommend the use during open-heart surgery of an omental pedicle graft in selected cases to prevent postoperative complications. Th...
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1991
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| Acceso en línea: | https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07302347_v18_n1_p8_Liotta http://hdl.handle.net/20.500.12110/paper_07302347_v18_n1_p8_Liotta |
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paper:paper_07302347_v18_n1_p8_Liotta2023-06-08T15:43:47Z Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection Mediastinitis omentum sternum surgical wound dehiscence surgical wound infection article coronary artery bypass graft diabetes mellitus human ischemic heart disease major clinical study mediastinitis obesity omentum priority journal sternotomy wound infection After cardiac surgery, healing can be delayed by sternal wound infection, particularly if mediastinitis develops. Because of the technical simplicity of omentopexy, we recommend the use during open-heart surgery of an omental pedicle graft in selected cases to prevent postoperative complications. This article describes our experience over a 4-month period (from 30 March 1989 through 2 August 1989) with this technique in 50 consecutive patients at moderate-to-high risk for postoperative sternal and mediastinal problems. The patients included 39 men (78%) and 11 women (22%), whose ages ranged from 22 to 83 years (mean, 55 years). Preoperative risk factors included extreme obesity, 13 patients (26%); chronic obstructive pulmonary disease, 13 patients (26%); diabetes mellitus, 6 patients (12%); obesity and diabetes, 8 patients (16%); and obesity, diabetes, and chronic obstructive pulmonary disease, 3 patients (6%). Operative risk factors included cardiac reoperation involving prolonged surgery, 6 patients (12%); bilateral mammary grafting, 17 patients (34%); and the need for prolonged (greater than 72-hour) mechanical respiratory assistance, 2 patients (4%). Three of the 50 patients (6%) were considered to be at moderate risk due to an increase in nosocomial infections at the time of their surgical procedures. Although the omentopexy itself caused no complications, 5 patients had major complications related to the cardiac procedure. Two of these patients died, for an operative mortality of 4%; death was caused by progressive peritonitis in 1 case and by cardiac tamponade in the other case. At least 2 of the remaining 3 patients withstood localized mediastinal infection and had thereafter an extremely benign postoperative course. We conclude that an omental pedicle graft, placed prophylactically in patients at risk for sternal wound infection, can serve as a valuable adjunct to healing after cardiac surgery. 1991 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07302347_v18_n1_p8_Liotta http://hdl.handle.net/20.500.12110/paper_07302347_v18_n1_p8_Liotta |
| institution |
Universidad de Buenos Aires |
| institution_str |
I-28 |
| repository_str |
R-134 |
| collection |
Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) |
| topic |
Mediastinitis omentum sternum surgical wound dehiscence surgical wound infection article coronary artery bypass graft diabetes mellitus human ischemic heart disease major clinical study mediastinitis obesity omentum priority journal sternotomy wound infection |
| spellingShingle |
Mediastinitis omentum sternum surgical wound dehiscence surgical wound infection article coronary artery bypass graft diabetes mellitus human ischemic heart disease major clinical study mediastinitis obesity omentum priority journal sternotomy wound infection Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| topic_facet |
Mediastinitis omentum sternum surgical wound dehiscence surgical wound infection article coronary artery bypass graft diabetes mellitus human ischemic heart disease major clinical study mediastinitis obesity omentum priority journal sternotomy wound infection |
| description |
After cardiac surgery, healing can be delayed by sternal wound infection, particularly if mediastinitis develops. Because of the technical simplicity of omentopexy, we recommend the use during open-heart surgery of an omental pedicle graft in selected cases to prevent postoperative complications. This article describes our experience over a 4-month period (from 30 March 1989 through 2 August 1989) with this technique in 50 consecutive patients at moderate-to-high risk for postoperative sternal and mediastinal problems. The patients included 39 men (78%) and 11 women (22%), whose ages ranged from 22 to 83 years (mean, 55 years). Preoperative risk factors included extreme obesity, 13 patients (26%); chronic obstructive pulmonary disease, 13 patients (26%); diabetes mellitus, 6 patients (12%); obesity and diabetes, 8 patients (16%); and obesity, diabetes, and chronic obstructive pulmonary disease, 3 patients (6%). Operative risk factors included cardiac reoperation involving prolonged surgery, 6 patients (12%); bilateral mammary grafting, 17 patients (34%); and the need for prolonged (greater than 72-hour) mechanical respiratory assistance, 2 patients (4%). Three of the 50 patients (6%) were considered to be at moderate risk due to an increase in nosocomial infections at the time of their surgical procedures. Although the omentopexy itself caused no complications, 5 patients had major complications related to the cardiac procedure. Two of these patients died, for an operative mortality of 4%; death was caused by progressive peritonitis in 1 case and by cardiac tamponade in the other case. At least 2 of the remaining 3 patients withstood localized mediastinal infection and had thereafter an extremely benign postoperative course. We conclude that an omental pedicle graft, placed prophylactically in patients at risk for sternal wound infection, can serve as a valuable adjunct to healing after cardiac surgery. |
| title |
Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| title_short |
Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| title_full |
Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| title_fullStr |
Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| title_full_unstemmed |
Routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| title_sort |
routine application of the omental pedicle graft in 50 consecutive patients at risk for sternal wound infection |
| publishDate |
1991 |
| url |
https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_07302347_v18_n1_p8_Liotta http://hdl.handle.net/20.500.12110/paper_07302347_v18_n1_p8_Liotta |
| _version_ |
1768544916405747712 |