eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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2/2006
vol. 3
 
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abstract:

Torakochirurgia
Is continuous irrigation drainage of the mediastinum a safe and effective method for the treatment of descending necrotizing mediastinitis?

Marek Rokicki
,
Wojciech Rokicki
,
Jacek Gawrychowski
,
Marek Filipowski

Kardiochir Torakochir Pol 2006; 3, 2: 169-173
Online publish date: 2006/08/31
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Introduction: Descending necrotizing mediastinitis (DNM) is a primary complication of cervical or odontogenical toxic infections that can spread to the mediastinum which is fraught with impressive morbidity and mortality rates of 30% to 40% or more. This is the report on a new combined surgical procedure consisting of cervical drainage, an aggressive mediastinal debridement via posterolateral thoracotomy plus continuous mediastinal irrigation Material and methods: Between 1999 and 2005 in our department this technique was used to treat nine patients with DNM. Results: The mean duration from first symptoms or: from the appearance of first symptoms to operation was 5 days (range 2-14), mean irrigation mediastini 9.5 days (range 5-14) and mean hospital stay was 24.4 days (range 5-39). Postoperative complications were found in four patients: three with infection post thoracotomy wound and one with pneumonia. Two patients died in the postoperative period: one died of multiorgan failure and the other of ARDS. Conclusions: Radical surgical debridement mediastini and a continuous, mediastinal irrigation drainage seem a safe and effective method for the treatment of DNM.
keywords:

descending necrotizing mediastinitis, irrigation drainage

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