Management of mediastinal infections after open—heart surgery in 18 cases

Two methods were employed in the management of 18 patients with mediastinal infec-tions after open-heart surgery in a 10-year-period from 1980 to 1989.The first 3 cases weretreated with local debridement and drainage of the involved areas.Of them,1 was cured and 2 de-veloped chronic osteomyelitis of the sternum with an average hospitalization of 91 d.The other 15cases were treated with radical debridement and closed retrosternal irrigation of antibiotic solutions.Fourteen out of the 15 cases were successfully cured with an average hospitalization of 15d and 1case suffered from a recurrence of infection.No hospital mortality occurred in this series and 2 latedeaths were not related to mediastinal infections.It is believed by the authors that radicaldebridement in association with retrosternal irrigation is a far much better method than localdebridement combined with drainage in the management of mediastinal infections afteropen-heart surgery.