High-pressure suction drainage via a polyurethane foam in the management of poststernotomy mediastinitis

Background. This study was performed to evaluate the effectiveness of sucti on drainage in the management of early poststernotomy mediastinitis. Methods. From September 1998 to August 1999, we encountered nine cases of p oststernotomy mediastinitis out of 1,209 adult median sternotomies performe d in this time period. All these cases were treated with suction drainage, which was recently introduced to our management protocol. From September 19 97 to August 1998, we encountered 11 cases of poststernotomy mediastinitis of 1,343 adult median sternotomies. All these cases were initially treated by closed drainage and irrigation, which was our previous first-line manage ment. We used the latter group as historical controls for the evaluation of suction drainage. Lengths of hospitalization were compared using the Mann- Whitney U test, and success versus failure of the primary treatment was com pared using the chi (2) test. Results. Treatment with the suction dressing resulted in a decreased length of hospitalization after treatment starts (p = 0.02) and a lower rate of t reatment failure (p = 0.03). Conclusions. The use of high-pressure suction drainage is a valuable adjunc t in the early management of poststernotomy mediastinitis. (Ann Thorac Surg 2000;70:1891-5) (C) 2000 by The Society of Thoracic Surgeons.