DIFFERENTIATED APPROACH IN THE TREATMENT OF PATIENTS WITH STERNOMEDIASTINITIS AFTER CARDIAC SURGERY

Abstract

OBJECTIVE. The objective is to develop differentiated tactic of surgical treatment of patients with postoperative sternomediastinitis.MATERIAL AND METHODS. The work is based on the results of treatment of 56 patients. The classification of sternomediastinitis by El Oakley & John E. Wright (1996) was used. Depending on the time of the plastic surgery, the patients were divided into two groups. I group (n = 32) consisted of patients got the plastic stage of the operation immediately after the sanative surgery. II group (n = 24) consisted of patients got the operative treatment in time-divided two stages. Patients of both groups were comparable in terms of key indicators. RESULTS. Recovery was achieved in 31 (96 %) patients in I group and in 21 (88 %) patients in II group. The duration of follow-up was between 6 months and 3 years.CONCLUSION. With the fifth type of sternomediastinitis according to El Oakley & John E. Wright (1996), it is advisable to perform a sanative and plastic surgery in the first stage. With the I–IV type of sternomediastinitis, it is advisable to separate the operation and conduct it in 2 stages.

Keywords

• sternmediastinitis
• surgical treatment