Метод комбінованого лікування медіастиніту після аортокоронарного шунтування

Post-sternotomy mediastinitis (PM) or deep wound sternal infection is one of the most dreaded complications after cardiac surgery. Thanks to modern hygiene standards in hospitals and the rational use of antibiotics, the overall prevalence of PM is generally considered low. In cases of coronary artery bypass grafting using the internal mammary artery, this rate can significantly increase. However, even if this complication is relatively rare, it is associated with high mortality and morbidity level. Deep wound sternal infection not only leads to bad outcomes but is also accompanied by significant morbidity in surviving patients, prolonged hospital stays, increased treatment costs, and a substantial deterioration in long-term survival rates. At present, there is no standard treatment regimen for PM. Clinicians can choose different methods depending on the classification form of the disease, but all without exception include three main concepts: infection control, classical, irrigation, or vacuum wound drainage, and its reconstruction. Today, surgeons continuously propose new treatment methods, all of them have its own advantages and disadvantages as well. We present a case report of successful combined treatment (vacuum therapy followed by thoracoplasty) of PM after coronary artery bypass grafting.