Pitfall in the computed-tomography-diagnosis of postcardiotomy infection: iodine accumulation after irrigation mimicking retrosternal abscess

Argitis, V.; Schnyder, P.; Segesser, Ludwig K. von

doi:10.1016/j.ejcts.2004.11.029

Cited by 2 publications

(2 citation statements)

References 5 publications

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“…Misawa et al showed that a mediastinal soft tissue mass combined with a bilateral pleural effusion can be a characteristic CT finding in poststernotomy infectious mediastinitis, and that chest CT is more sensitive for detecting sternal dehiscence, sternal erosion, and subcutaneous fluid accumulation. Erroneous diagnoses due to surgical packing, surgical (manufactured by Ethicon—A Johnson & Johnson Family of Companies, Piscataway, NJ, USA), body foreign reaction, or iodine accumulation following irrigation have been reported.…”

Section: Evidence Of Infectionmentioning

confidence: 99%

Mediastinitis Following Pediatric Cardiac Surgery

et al. 2013

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Younger age, malnutrition, preoperative respiratory tract infection, high American anesthesiology score, longer duration of surgery, prolonged ventilation, and ICU stay were definite risk factors for mediastinitis. Early primary closure over drains, vacuum-assisted closure, muscle flap, and omental flap remain the most frequently performed treatments for post-sternotomy mediastinitis. Vacuum-assisted closure has emerged as the technique of choice in recent years.

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Section: Evidence Of Infectionmentioning

confidence: 99%

Mediastinitis Following Pediatric Cardiac Surgery

et al. 2013

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“…CT scans have been considered of great value to localize infected tissues [52] , however, there is also some doubt about the validity of a CT scan in performing an early diagnosis [53,54] . Furthermore, erroneous diagnoses due to Surgicel packing [55] , to Surgicel body foreign reaction [56] or to iodine accumulation following irrigation [57] have been reported.…”

Section: Diagnosismentioning

confidence: 99%

Mediastinitis in pediatric cardiac surgery: Prevention, diagnosis and treatment

Durandy¹

2010

WJC

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In spite of advances in the management of mediastinitis following sternotomy, mediastinitis is still associated with significant morbidity. The prognosis is much better in pediatric surgery compared to adult surgery, but the prolonged hospital stays with intravenous therapy and frequent required dressing changes that occur with several therapeutic approaches are poorly tolerated. Prevention includes nasal decontamination, skin preparation, antibioprophylaxis and air filtration in the operating theater. The expertise of the surgical team is an additional factor that is difficult to assess precisely. Diagnosis is often very simple, being made on the basis of a septic state with wound modification, while retrosternal puncture and CT scan are rarely useful. Treatment of mediastinitis following sternotomy is always a combination of surgical debridement and antibiotic therapy. Continued use of numerous surgical techniques demonstrates that there is no consensus and the best treatment has yet to be determined. However, we suggest that a primary sternal closure is the best surgical option for pediatric patients. We propose a simple technique with high-vacuum Redon's catheter drainage that allows early mobilization and short term antibiotherapy, which thus decreases physiological and psychological trauma for patients and families. We have demonstrated the efficiency of this technique, which is also cost-effective by decreasing intensive care and hospital stay durations, in a large group of patients.

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Pitfall in the computed-tomography-diagnosis of postcardiotomy infection: iodine accumulation after irrigation mimicking retrosternal abscess

Cited by 2 publications

References 5 publications

Mediastinitis Following Pediatric Cardiac Surgery

Mediastinitis Following Pediatric Cardiac Surgery

Mediastinitis in pediatric cardiac surgery: Prevention, diagnosis and treatment

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