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Analysis on Risk Factors and Preventive Measures of Median Sternal Wound Infection

Author: CaiYueJie
Tutor: ZuoFaZhi
School: Fudan University
Course: Plastic Surgery
Keywords: Sternotomy Risk factors The sternotomy several infection Complication Pectoralis major muscle flap Titanium plate fixation
CLC: R654.2
Type: Master's thesis
Year: 2011
Downloads: 25
Quote: 0
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Abstract


The first part of median sternotomy incision postoperative infection risk factors analysis [Objective analysis affect sternotomy once infection risk factors. [Methods] is selected from the group consisting of Zhongshan Hospital between January 2008 to February 2011, adults (≥ 16 years) in cardiac surgery received standard median sternotomy split incision means the purposes of open heart surgery patients, a total of 7056 cases, univariate and multivariate analysis of the outcome. [Results] 73 patients sternal wound infection occurs, the rate was 1.03%. Primary disease, such as old myocardial infarction, congestive heart failure exists; obesity; different surgical approach; postoperative ICU stay duration; whether emergency surgery; poor blood sugar regulation and postoperative important factor for the incision once infection. [Conclusion] active treatment and prevention, to avoid too many risk factors exist in the perioperative incision infection. The second part of the sternotomy repeated analysis of risk factors for infection [Objective analysis of multiple infections affect sternotomy risk factors. [Methods] from January 2008 to February 2011, adults (age ≥ 16 years), poor healing of sternotomy, sternal partially or completely not healing, even mediastinal infection in orthopedic line sternal incision debridement suture surgery, a total of 46 cases, which repeated the line once more than a total of 30 cases debridement incision infection. By univariate and multivariate analysis of risk factors for recurrent infections come incision 【Results】 30 cases Ⅱ occur repeatedly sternal wound infection, accounting for 65.22%. Age gt; 70 years old, debridement before incision defect of the working class, once debridement postoperative blood glucose adjustment, the postoperative sternal stability is bad for the repeated median sternotomy incision infection. [Conclusion] grasp and reduce the occurrence of risk factors, through the analysis of the results, to reduce the chance of recurrence and postoperative complications. The third part of the sternum stability sternotomy healing 【Objective】 titanium plate fixation of the sternum, chest wall reconstruction, advancing bilateral pectoralis major muscle flap surgery feasibility sternal debridement to reduce postoperative the possibility of recurrence. [Methods] is selected from the group consisting of Zhongshan Hospital between January 2008 to February 2011, adults (≥ 16 years of age) in our hospital orthopedic hospital treatment, according to the screening criteria, a total of 26 patients. The 26 patients were divided into A, B groups. A group for traditional pectoralis major muscle flap tamponade, group B titanium plate fixed to the pectoralis major muscle flap. Perioperative comparison of 2 groups, respectively. [Results] A group of 13 patients, 5 patients again sternotomy infection, group B only one case of postoperative bleeding. Group B drainage tube removed earlier in Group A disconnect time. [Conclusion] full dressing of the timing of the application, the appropriate timing of surgery and titanium plate fixation sternum applications, greatly improving a median sternotomy incision healing rate, significantly reduce the possibility of recurrence. Titanium plate technology reduces the incidence of post-operative complications.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Heart
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