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Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review
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 de...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247689/ https://www.ncbi.nlm.nih.gov/pubmed/25417190 http://dx.doi.org/10.1186/s13019-014-0179-4 |
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author | van Wingerden, Jan J Ubbink, Dirk T van der Horst, Chantal MAM de Mol, Bas AJM |
author_facet | van Wingerden, Jan J Ubbink, Dirk T van der Horst, Chantal MAM de Mol, Bas AJM |
author_sort | van Wingerden, Jan J |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4247689 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-42476892014-11-30 Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review van Wingerden, Jan J Ubbink, Dirk T van der Horst, Chantal MAM de Mol, Bas AJM J Cardiothorac Surg Review 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. BioMed Central 2014-11-23 /pmc/articles/PMC4247689/ /pubmed/25417190 http://dx.doi.org/10.1186/s13019-014-0179-4 Text en © van Wingerden et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review van Wingerden, Jan J Ubbink, Dirk T van der Horst, Chantal MAM de Mol, Bas AJM Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title | Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title_full | Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title_fullStr | Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title_full_unstemmed | Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title_short | Poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
title_sort | poststernotomy mediastinitis: a classification to initiate and evaluate reconstructive management based on evidence from a structured review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247689/ https://www.ncbi.nlm.nih.gov/pubmed/25417190 http://dx.doi.org/10.1186/s13019-014-0179-4 |
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