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Kabanov M.Yu.

Hospital for War Veterans;
Mechnikov North-Western State Medical University

Kryukov N.A.

Hospital for War Veterans

Binienko M.A.

Hospital for War Veterans

Kravtsova O.S.

Hospital for War Veterans

Belikova M.Ya.

Hospital for War Veterans

Sementsov K.V.

Hospital for War Veterans;
Mechnikov North-Western State Medical University

Treatment of postoperative anterior mediastinitis, sternal osteomyelitis in a patient with a novel coronavirus infection

Authors:

Kabanov M.Yu., Kryukov N.A., Binienko M.A., Kravtsova O.S., Belikova M.Ya., Sementsov K.V.

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Journal: Pirogov Russian Journal of Surgery. 2021;(4): 53‑57

DOI: 10.17116/hirurgia202104153

Views: 2602

Downloaded: 65

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To cite this article:

Kabanov MYu, Kryukov NA, Binienko MA, Kravtsova OS, Belikova MYa, Sementsov KV. Treatment of postoperative anterior mediastinitis, sternal osteomyelitis in a patient with a novel coronavirus infection. Pirogov Russian Journal of Surgery. 2021;(4):53‑57. (In Russ.)
https://doi.org/10.17116/hirurgia202104153

Подписка 2025 (Pirogov Russian Journal of Surgery)
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The incidence of mediastinitis after median sternotomy makes up 1-3%. This complication results prolonged hospital-stay, significant increase in treatment cost and high mortality (up to 75%). Severe COVID-19 pneumonia is often manifested by coughing, that impairs sternum stability after osteosynthesis. Moreover, concomitant leukopenia increases the risk of mediastinitis. Viral pneumonia and mediastinitis are complicated by respiratory failure and mutually potentiate the negative effect. Negative pressure wound therapy (NPWT) with combined antibiotic therapy ensures a favorable outcome even in patients with postoperative mediastinitis and osteomyelitis combined with viral pneumonia.

Keywords:

postoperative sternal osteomyelitis
anterior mediastinitis
sternomediastinitis
novel coronavirus infection
COVID-19

Authors:

Kabanov M.Yu.

Hospital for War Veterans;
Mechnikov North-Western State Medical University

Kryukov N.A.

Hospital for War Veterans

Binienko M.A.

Hospital for War Veterans

Kravtsova O.S.

Hospital for War Veterans

Belikova M.Ya.

Hospital for War Veterans

Sementsov K.V.

Hospital for War Veterans;
Mechnikov North-Western State Medical University

Received:

31.07.2020

Accepted:

12.10.2020

List of references:

  1. Lafci G, Yasar E, Cicek OF, et al. A novel modified Robicsek technique for sternal closure: “Double-check”. Asian Cardiovasc Thorac Ann. 2013;22(6):758-760.  https://doi.org/10.1177/0218492313497207
  2. Milton H. Mediastinal surgery. Lancet. 1897;1:892-875. 
  3. Fawzy H, Alhodaib N, Mazer CD, et al. Sternal plating for primary and secondary sternal closure; can it improve sternal stability? J Cardiothorac Surg. 2009;4:19.  https://doi.org/10.1186/1749-8090-4-19
  4. Vishnevsky AA, Rudakov SS, Milanov IO. Khirurgiya grudnoj stenki: rukovodstvo. M.: Vidar; 2005. (In Russ.).
  5. Franco S, Herrera AM, Atehortua M, Velez L, Botero J, Jaramillo JS, Velez JF, Fernandez H. Use of steel bands in sternotomy closure: implications in high-risk cardiac surgical population. Interact. Cardiovasc Thorac Surg. 2009;8:200-205.  https://doi.org/10.1510/icvts.2008.188136
  6. Morisaki A, Hosono M, Sasaki Y, Hirai H, Sakaguchi M, Nakahira A, Seo H, Suehiro S, Shibata T. Evaluation of risk factors for hospital mortality and current treatment for poststernotomy mediastinitis. Gen Thoracic Cardiovasc Surg. 2011;59(4):261-267.  https://doi.org/10.1007/s11748-010-0727-3
  7. Natsional’nyie klinicheskie rekomendatsii. Torakal’naya khirurgiya. Yablonsky PK, ed. M.: GEOTAR-Media; 2014. (In Russ.).
  8. Komissarov IA, Komolkin IA, Afanasiev AP. Deformations of the chest in children. Pediatr. 2010;1(1):63-66. (In Russ.).
  9. Bassetti M. The Novel Chinese Coronavirus (2019-nCoV) Infections: challenges for fighting the storm. Eur J Clin Invest. 2020;50(3):e13209. https://doi.org/10.1111/eci.13209
  10. Guan WJ, Ni ZY, Hu Y, Liang W, Ou C, He J, Liu L, Shan H, Lei C, Hui DSC, Du B, Li L. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708‐1720. https://doi.org/10.1056/NEJMoa2002032
  11. Chen SZ, Li J, Li XY, Xu L. Effects of vacuum assisted closure on wound microcirculation: an experimental study. Asian J Surg. 2005;28(3): 211-217.  https://doi.org/10.1016/S1015-9584(09)60346-8
  12. Joseph E, Hamori CA, Bergman S, Roaf E, Swann NF, Anastasi GW. A prospective randomized trial of vacuum assisted closure versus standard therapy of chronic non-healing wounds. Wounds. 2000;12(3): 60-67. 
  13. https://static-1.rosminzdrav.ru/system/attachments/attaches/000/049/951/original/09042020_%D0%9C%D0%A0_COVID-19_v5.pdf 

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