Effective Combination of Incisional Negative Pressure Wound Therapy and Radical Reconstructive Surgery in the Treatment of Post-Sternotomy Mediastinitis Caused by Methicillin Resistant Staphylococcus aureus

Aref Rashed¹ *, Ágnes Beledi¹, Nasri Alotti¹ and Zsofia Verzar²

Received: February 23, 2018;   Published: March 01, 2018

DOI: 10.26717/BJSTR.2018.02.000812

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Abstract

Although rare, post-sternotomy mediastinitis is still a major concern after open heart surgery. Contamination with multi-resistant pathogens is a serious problem, as they fall outside the spectrum of the generally applied antimicrobial prophylaxis. Along with radical surgery, incisional negative-pressure wound therapy may be useful in preventing reinfection. We present a case of a 68-year old woman who underwent open heart surgery and developed post-sternotomy mediastinitis due to methicillin-resistant Staphylococcus aureus. Intravenous antibiotic therapy with multiple sternum-preserving surgical debridement was insufficient to decontaminate the wound and achieve proper healing. After radical surgical debridement and reconstruction in combination with incisional negative-pressure wound therapy, final wound healing occurred with no sign of reinfection in the follow-up period. Combining incisional negative-pressure wound therapy with radical surgical debridement and reconstruction may be the most appropriate way to decontaminate wounds infected by multiresistant organisms.

Keywords: Methicillin-Resistant Staphylococcus aureus; Negative Pressure Wound Therapy; Post-Sternotomy Mediastinitis

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