Faculty Collaboration Database

Management of postoperative infections after the minimally invasive pectus excavatum repair. J Pediatr Surg 2005 Jun;40(6):1004-7; discussion 1007-8

Date

07/02/2005

Pubmed ID

15991186

DOI

10.1016/j.jpedsurg.2005.03.017

Scopus ID

2-s2.0-20544474233 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

PURPOSE: Pectus excavatum is frequently repaired using the minimally invasive placement of a substernal bar (Nuss procedure). Infectious complications after the Nuss procedure are potentially devastating. To date, the management of postoperative infectious complications has not been well described.

METHODS: A retrospective review of all patients (N = 168) who underwent the Nuss procedure from January 1, 1997, to October 1, 2003, at our institution was performed. Six patients (4%) had postoperative infections, and their medical records were reviewed.

RESULTS: Of the 6 patients, 5 underwent operative drainage for wound abscesses that developed 2 to 76 weeks postoperatively. The other patient developed cellulitis 12 months postoperatively and was treated effectively with antibiotics alone. Recurrent infections were treated in 3 of 6 patients, one of whom eventually required removal of the bar resulting in a mild, residual pectus excavatum defect. One of 6 patients has had the substernal bar removed electively. The remaining 4 continue to be without clinically apparent infection at this time and are over 1 year removed from their infection.

CONCLUSIONS: Although uncommon, infectious complications after the Nuss procedure require complex management strategies. Despite recurrent infection in some cases, most infectious complications occurring after the minimally invasive repair can be effectively treated without having to remove the substernal bar.

Author List

Calkins CM, Shew SB, Sharp RJ, Ostlie DJ, Yoder SM, Gittes GK, Snyder CL, Guevel W, Holcomb GW 3rd

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Abscess
Administration, Oral
Adolescent
Anti-Bacterial Agents
Cellulitis
Child
Child, Preschool
Female
Funnel Chest
Humans
Infusions, Intravenous
Male
Minimally Invasive Surgical Procedures
Retrospective Studies
Staphylococcal Infections
Surgical Wound Infection
Treatment Outcome
Wound Healing