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Open Access 01-12-2014 | Review

Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review

Authors: Jan J van Wingerden, Dirk T Ubbink, Chantal MAM van der Horst, Bas AJM de Mol

Published in: Journal of Cardiothoracic Surgery | Issue 1/2014

Abstract

Early recognition and, where possible, avoidance of risk factors that contribute to the development of poststernotomy mediastinitis (PSM) form the basis for successful prevention. Once the presence of PSM is diagnosed, the known risk factors have been shown to have limited influence on management decisions. Evidence-based knowledge on treatment decisions, which include the extent and type of surgical intervention (other than debridement), timing and others is available but has not yet been incorporated into a classification on management decisions regarding PSM. Ours is a first attempt at developing a classification system for management of PSM, taking the various evidence-based reconstructive options into consideration. The classification is simple to introduce (there are four Types) and relies on the careful establishment of two variables (sternal stability and sternal bone viability and stock) prior to deciding on the best available reconstructive option. It should allow better insight into why treatment decisions fail or have to be altered and will allow better comparison of treatment outcomes between various institutions.

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Title: Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review
Authors: Jan J van Wingerden
Dirk T Ubbink
Chantal MAM van der Horst
Bas AJM de Mol
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Cardiothoracic Surgery / Issue 1/2014
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-014-0179-4

At a glance: The STEP trials

Springer Medicine

Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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