Vacuum-Assisted Closure for Mediastinitis Caused by Methicillin-Resistant Staphylococcus aureus after Coronary Artery Bypass Grafting
10.4326/jjcvs.38.248
- VernacularTitle:冠動脈バイパス術後メチシリン耐性ブドウ球菌（MRSA）縦隔洞炎に対し持続陰圧吸引 vacuum assisted wound closure （VAC）療法が有効であった1例
- Author:
Atsushi Yuda
;
Sakashi Noji
;
Takayuki Tatebayashi
- Publication Type:Journal Article
- From:Japanese Journal of Cardiovascular Surgery
2009;38(4):248-251
- CountryJapan
- Language:Japanese
-
Abstract:
Mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA) is a severe complication after coronary artery bypass grafting (CABG). Vacuum-Assisted Closure (VAC) therapy is a technical innovation in wound care. The advantage of VAC is the application of negative pressure to sternal wounds. A 73-year-old man was admitted to our hospital because of operation for triple vessel disease including left main coronary artery lesion. Off-pump CABG was performed using the bilateral internal thoracic arteries and right gastroepiploic artery. The postoperative course was uneventful. However, purulent discharge from a median sternostomy wound appeared on the 11th postoperative day. MRSA was identified by the culture of the wound exudate. On operation, the necrotic tissue was removed, and continuous irrigation and drainage were performed. Conventional technique was not effective. VAC therapy was applied on the 35th postoperative day. During VAC therapy, the wound became smaller and granulation tissue proliferated. VAC therapy was discontinued on the 208th postoperative day. Finally, the wound was naturally closed. He was discharged in good condition on the 213th postoperative day. VAC therapy was an effective treatment for MRSA mediastinitis after cardiac surgery.
