Medical and Social Expert Evaluation and RehabilitationMedical and Social Expert Evaluation and RehabilitationМедико-социальная экспертиза и реабилитация1560-95372412-2092Eco-Vector3452610.17816/MSER34526ArticlesСтатьиResearch ArticleSternomastoid after cardiac interventions (questions treatment and rehabilitation)Стерномедиастинит после кардиохирургических вмешательств (вопросы лечения и реабилитации)https://orcid.org/0000-0002-6975-58021021-8030KosenkovAlexandr N.КосенковАлександр Николаевич
Russian Federation

д.м.н.

alenkos@rambler.ruhttps://orcid.org/0000-0003-0433-2523VinokurovIvan A.ВинокуровИван Андреевич
Russian Federation

к.м.н.

docvin.med@gmail.comhttps://orcid.org/0000-0002-4537-4204Al-UsefAmjat NasrАль-ЮсефАмжат Наср
Russian Federation
Amjad@inbox.ruI.M. Sechenov First Moscow State Medical University (Sechenov University)ГБOУ ВПO «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздравa России (Сеченовский Университет)Petrovsky National Research Center of SurgeryФГБНУ «Российский научный центр хирургии имени академика Б.В. Петровского»1508202023118230306202008062020Copyright ©; 2020, Eco-VectorCopyright ©; 2020, ООО "Эко-Вектор"2020Eco-VectorООО "Эко-Вектор"https://rjmseer.com/1560-9537/article/view/34526

Sternomediastinitis is one of the formidable complications of cardiac surgery with high disability mortality up to 40%. The introduction of a vacuum-assisted dressing, as well as active surgical technologies in the treatment of these patients, have reduced the duration of hospitalization, the level of disability and mortality. However, a number of unresolved issues remain related to the rehabilitation of these patients.

Стерномедиастинит является одним из грозных осложнений кардиохирургических вмешательств с высокой инвалидизацией и летальностью до 40%. Внедрение вакуум-ассистированной повязки, а также активные хирургические технологии в лечении этих больных позволили снизить продолжительность госпитализации, уровень инвалидизации и летальности. Однако остаётся ряд нерешённых вопросов, связанных с реабилитацией этих больных.

sternomediastinitisvacuum-assisted dressingsurgical treatmentrehabilitationстерномедиастинитвакуум-ассистированная повязкахирургическое лечениереабилитацияDalton ML, Connally SR, Sealy WC. Julian’s reintroduction of Milton’s operation. Ann Thorac Surg. 1992;53(3):532–533. https://doi.org/10.1016/0003-4975(92)90293-d.Graf K, Ott E, Vonberg RP, et al. Economic aspects of deep sternal wound infections. Eur J Cardiothorac Surg. 2010;37(4):893–896. https://doi.org/10.1016/j.ejcts.2009.10.005.Lucet JC. Surgical site infection after cardiac surgery: a simplified surveillance method. Infect Control Hosp Epidemiol. 2006;27(12):1393–1396. https://doi.org/10.1086/509853.Filsoufi F, Castillo JG, Rahmanian PB, et al. Epidemiology of deep sternal wound infection in cardiac surgery. J Cardiothorac Vasc Anesth. 2009;23(4):488–494. https://doi.org/10.1053/j.jvca.2009.02.007.Shine TS, Uchikado M, Crawford CC, Murray MJ. Importance of perioperative blood glucose management in cardiac surgical patients. Asian Cardiovasc Thorac Ann. 2007;15(6):534–538. https://doi.org/10.1177/021849230701500621.Abboud CS, Wey SB, Baltar VT. Risk factors for mediastinitis after cardiac surgery. Ann Thorac Surg. 2004;77(2):676–683. https://doi.org/10.1016/S0003-4975(03)01523-6.Kubota H, Miyata H, Motomura N, et al. Deep sternal wound infection after cardiac surgery. J Cardiothorac Surg. 2013;8:132. https://doi.org/10.1186/1749-8090-8-132.Lepelletier D, Perron S, Bizouarn P, et al. Surgical-site infection after cardiac surgery: incidence, microbiology, and risk factors. Infect Control Hosp Epidemiol. 2005;26(5):466–472. https://doi.org/10.1086/502569.Lepelletier D, Poupelin L, Corvec S, et al. Risk factors for mortalityin patients with mediastinitis after cardiac surgery. Arch Cardiovasc Dis. 2009;102(2):119–125. https://doi.org/10.1016/j.acvd.2008.11.003.Lepelletier D, Lucet JC. Controlling meticillin-susceptible Staphylococcusaureus: not simply meticillin-resistant S. aureusrevisited. J Hosp Infect. 2013;84(1):13–21. https://doi.org/10.1016/j.jhin.2013.01.010.AnderssonAE, BerghI, KarlssonJ, et al. Traffic flowin the operating room: an explorative and descriptive study on air quality during orthopedic trauma implant surgery. Am J Infect Control. 2012;40(8):750–755. https://doi.org/10.1016/j.ajic.2011.09.015.Le Guillou V, Tavolacci MP, Baste JM, et al. Surgical site infection after central venous catheter-related infection in cardiac surgery. Analysis of a cohort of 7557 patients. J Hosp Infect. 2011;79(3):236–241. https://doi.org/10.1016/j.jhin.2011.07.004.Chan M, Yusuf E, Giulieri S, et al. A retrospective study of deep sternal wound infections: clinical and microbiological characteristics, treatment, and risk factors for complications. Diagn Microbiol Infect Dis. 2015;84(3):261−265. https://doi.org/10.1016/j.diagmicrobio.2015.11.011.Barnea Y, Carmeli Y, Kuzmenko B, et al. Staphylococcus aureus mediastinitis and sternalosteomyelitis following median sternotomy in a rat model. J Antimicrob Chemother. 2008;62(6):1339–1343. https://doi.org/10.1093/jac/dkn378.Cunha BA. Osteomyelitis in elderly patients. Clin Infect Dis. 2002;35(3):287–293. https://doi.org/10.1086/341417.Elgharably H, Mann E, Awad H, et al. First evidence of sternal wound biofilm following cardiac surgery. PLoS One. 2013;8(8):e70360. https://doi.org/10.1371/journal.pone.0070360.Parsek MR, Singh PK. Bacterial biofilms: an emerging link to disease pathogenesis. Annu Rev Microbiol. 2003;57:677–701. https://doi.org/10.1146/annurev.micro.57.030502.090720.Ellenrieder M, Redanz S, Bader R, et al. Influence of antimicrobial coatings of vacuum-assisted closure dressings on methicillin-resistant Staphylococcus aureus growth kinetics: an invitro study. Surg Infect (Larchmt). 2015;16(2):139–145. https://doi.org/10.1089/sur.2013.268.Mangram AJ, Horan TC, Pearson ML, et al. Guideline for Prevention of Surgical Site Infection, 1999. Centersfor Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97−132; quiz 133-134.Izaddoost S, Withers EH. Sternal reconstruction with omental and pectoralis flaps: a review of 415 consecutive cases. Ann Plast Surg. 2012;69(3):296−300. https://doi.org/10.1097/SAP.0b013e31822af843.Wong CH, Senewiratne S, Garlick B, Mullany D. Two-stage management of sternal wound infection using bilateral pectoralis major advance oment flap. Eur J Cardiothorac Surg. 2006;30(1):148−152. https://doi.org/10.1016/j.ejcts.2006.03.049.Biefer RH, Sündermann SH, Emmert MY, et al. Negative microbiological results are not mandatory in deep sternal wound infections before wound closure. Eur J Cardiothorac Surg. 2012;42(2):306−310. https://doi.org/10.1093/ejcts/ezr326.Catarino PA, Chamberlain MH, Wright NC, et al. High-pressure suction drainage via polyurethane foam in the management of poststernotomy mediastinitis. Ann Thorac Surg. 2000;70(6):1891−1895. https://doi.org/10.1016/s0003-4975(00)02173-1.Falagas ME, Tansarli GS, Kapaskelis A, et al. Impact of vacuum-assisted closure (VAC) therapy on clinical outcomes of patients with sternal wound infections: a meta-analysis of non randomized studies. PLoS One. 2013;8(5):e64741. https://doi.org/10.1371/journal.pone.0064741.Ennker IC, Pietrowski D, Vöhringer L, et al. Surgical debridement, vacuum therapy and pectoralis plasty in post sternotomy mediastinitis. J Plas tReconstr Aesthet Surg. 2009; 62(11):1479−1483. https://doi.org/10.1016/j.bjps.2008.05.017.Vos RJ, Yilmaz A, Sonker U, et al. Vacuum-assisted closure of post-sternotomy mediastinitis as compared to open packing. Interact Cardiovasc Thorac Surg. 2012;14(1):17−21. https://doi.org/10.1093/icvts/ivr049.Yu AW, Rippel RA, Smock E, et al. In patients with post-sternotomy mediastinitis is vacuum-assisted closure superior to conventional therapy? Interact Cardiovasc Thorac Surg. 2013;17(5):861−865. https://doi.org/10.1093/icvts/ivt326.Pericleous A, Dimitrakakis G, Photiades R, et al. Assessment of vacuum-assisted closure therapy on the wound healing process in cardiac surgery. Int Wound J. 2016;13(6):1142−1149. https://doi.org/10.1111/iwj.12430.Assmann A, Boeken U, Feindt P, et al. Vacuum-assisted wound closure is superior to primary rewiring in patients with deep sternal wound infection. Thorac Cardiovasc Surg. 2011;59(1):25–29. https://doi.org/10.1055/s-0030-1250598.Liu D, Zhang L, Li T, et al. Negative-pressure wound therapy enhances local inflammatory responses in acute infected soft-tissue wound. Cell Biochem Biophys. 2014;70(1):539–547. https://doi.org/10.1007/s12013-014-9953-0.Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997;38(6):553–562. https://doi.org/10.1097/00000637-199706000-00001.Jungius KP, Chilla BK, Labler L, et al. [Non-invasive assessment of the perfusion of wounds using power Doppler imaging: vacuum assisted closure versus direct wound closure. (In German)]. Ultraschall Med. 2006;27(5):473–477. https://doi.org/10.1055/s-2005-859001.Petzina R, Gustafsson L, Mokhtari A, et al. Effect of vacuum-assisted closure on blood flowin the peristernal thoracic wall after internal mammary artery harvesting. Eur J Cardiothorac Surg. 2006;30(1):85–89. https://doi.org/10.1016/j.ejcts.2006.04.009.Petzina R, Ugander M, Gustafsson L, et al.Topical negative pressure therapy of a sternotomy wound increases sternal fluid content but does not affect in sternal thoracic artery blood flow: assessment using magnetic resonance imaging. J Thorac Cardiovasc Surg. 2008;135(5):1007–1013. https://doi.org/10.1016/j.jtcvs.2007.09.070.Hu C, Zhang T, Ren B, etal. Effect of vacuum-assisted closure combined with open bone grafting to promote rabbit bone graft vascularization. Med Sci Monitor. 2015;21:1200–1206. https://doi.org/10.12659/MSM.892939.Zhou M, Yu A, Wu G, et al. Role of different negative pressure values in the process of infected wound streated by vacuum-assisted closure: an experimental study. Int Wound J. 2013;10(5):508–515. https://doi.org/10.1111/j.1742-481X.2012.01008.x.Deschka H, Machner M, Wimmer-Greinecker G. Presternal false aneurysm due to osse ous arrosion of the right ventricle. Thorac Cardiovasc Surg. 2013;61(3):261–263. https://doi.org/10.1055/s-0032-1327761.Sjogren J, Gustafsson R, Nilsson J, et al. Negative-pressure wound therapy following cardiac surgery: bleeding complications and 30-day mortality in 176 patients with deep sterna wound infection. Interact Cardiovasc Thorac Surg. 2001;12(2):117–120. https://doi.org/10.1510/icvts.2010.252668.Petzina R, Malmsjo M, Stamm C, et al. Major complications during negative pressure wound therapy in poststernotomy mediastinitis after cardiac surgery. J Thorac Cardiovasc Surg. 2010;140(5):1133–1136. https://doi.org/10.1016/j.jtcvs.2010.06.063.Sartipy U, Lockowandt U, Gabel J, et al. Cardiac rupture during vacuum-assisted closure therapy. Ann Thorac Surg. 2006;82(3):1110–1111. https://doi.org/10.1016/j.athoracsur.2006.01.060.Santarpino G, Pollari F, Fischlein TJ. Sternal closure following negative pressure wound therapy: a safe approach with a new titanium device. Int J Artif Organs. 2014;37(3):264–269. https://doi.org/10.5301/ijao.5000295.Lafferty PM, Anavian J, Will RE, Cole PA. Operative treatment of chest wall injuries: indications, technique, and outcomes. J Bone Joint Surg Am. 2011;93(1):97–110. https://doi.org/10.2106/JBJS.I.00696.Cataneo AJ, Cataneo DC, de Oliveira FH, et al. Surgical versus non surgical interventions for flail chest. Cochrane Database Syst Rev. 2015;7:CD009919. https://doi.org/10.1002/14651858.CD009919.pub2.Zhang Y, Tang X, Xie H, et al. Comparison of surgical fixation and nonsurgical management of flail chest and pulmonary contusion. Am J Emerg Med. 2015;33(7):937–940. https://doi.org/10.1016/j.ajem.2015.04.005.Boustany AN, Ghareeb P, Lee K. Prospective, randomized, single blinded pilot study of a new Flat Wire based sternal closure system. J Cardiothorac Surg. 2014;9:97. https://doi.org/10.1186/1749-8090-9-97.Bejko J, Bottio T, Tarzia V, et al. Nitinol flexi grip sternal closure system and standard sternal steel wiring: in sight from a matched comparative analysis. J Cardiovasc Med (Hagerstown). 2015;16(2):134–138. https://doi.org/10.2459/JCM.0000000000000025.Shumann NH, Huston TL. Reconstruction of the chest – congenital and acquiredanomalies and effects. In: Serletti JM, ed. Current reconstructive surgery. McGraw-Hill Medical, New York; 2013. Р. 713−718.Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: an overview of Cochrane systematicreviews. Cochrane Database Syst Rev. 2014;12:CD011273. https://doi.org/10.1002/14651858.CD011273.pub2.De Jong MB, Kokke MC, Hietbrink F, Leenen LP. Surgical management of rib fractures: strategies and literature review. Scand J Surg. 2014;103(2):120–125. https://doi.org/10.1177/1457496914531928.Schlitt A, Wischmann P, Wienke A, et al. Rehabilitation in patients with coronary heart disease: participation and its effect on prognosis. Dtsch Arztebl Int. 2015;112(31-32):527–534. https://doi.org/10.3238/arztebl.2015.0527.