Eur J Cardiothorac Surg 2002;21:767
© 2002 Elsevier Science NL
Reply to Totaro et al. and Szerafin et al.
P. Schroeyers,
F. Wellens*,
I. Degrieck,
R. Degeest,
F. Van Praet,
Y. Vermeulen,
H. Vanermen
Department of Thoracic and Cardiovascular Surgery, OLV Hospital, Moorselbaan 164, Aalst B-9300, Belgium
Received 14 January 2002;
accepted 15 January 2002.
* Corresponding author. Tel.: +32-53-72-45-99; fax: +32-53-72-45-52
e-mail: francis.wellens{at}olvz-aalst.be
The comments of Totaro et al. [2] and Szerafin et al. [3] are extremely valuable and demonstrate the evolution to a more uniform treatment for poststernotomy mediastinitis. Recognizing the subgroups as described by both authors followed by a well defined surgical strategy will offer the best results for this difficult problem. In view of our published results [1] we also changed to a two stage procedure in unstable patients. Initially open wound dressing will be performed in those patients, followed by closure with omentum and/or muscle flap in a second stage. The time frame between the two procedures is determined by the local aspect of the wound and the general status of the patient.
References
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Schroeyers P., Wellens F., Degrieck I., Degeest R., Van Praet F., Vermeulen Y., Vanermen H. Agressive primary treatment for poststernotomy acute mediastinitis our experience with omental and muscle flaps surgery. Eur J Cardiothorac Surg 2001;20:743-746.[Abstract/Free Full Text]
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Totaro P, Borghetti V, Lanzi S, Minszioni G. Primary omental flap surgery for post-sternotomy acute mediastinitis. Eur J Cardio-thorac Surg 2002;21(4):765.
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Szerafin T, Jaber O, Péterffy A. Technical refinements of omentopexy and pectoralis myoplasty for poststernotomy mediastinitis. Eur J Cardio-thorac Surg 2002;21(4):766.
