[HSF] anaerobic late mediastinitis

[Donald Ross]

Wouldn't you rather have yoghurt in your mediastinum than shit?
DR
On 24/03/2007, at 7:01 AM, psimha wrote:

> Funny to think that theworld was not stunned when they used a  
> fungus  basically a rotting thing from a piece of bread to cure  
> many diseases (Penicillin). That did not make people "curdle"
> How about spider webs , snake venom , potato peel etc etc.
> Prasanna
> Ajit Damle wrote:
>> I am too stunned to comment on "Yogurt in mediastinum".
>>
>> To my unsophisticated mind it seems that infection (leading to  
>> eventual
>> death) will not be controlled unless the prosthetic graft is  
>> replaced with a
>> homograft, if it does.
>>
>> Does anyone know if infection in a vascular graft in such a  
>> situation can be
>> controlled without replacing it?
>>
>> Ajit Damle
>>
>>
>>
>> -----Original Message-----
>> From: openheart-l-bounces at lists.hsforum.com
>> [mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of  
>> prasannasimha
>> Sent: Friday, March 23, 2007 11:04 AM
>> To: OpenHeart-L at lists.hsforum.com
>> Subject: Re: [HSF] anaerobic late mediastinitis
>>
>> Keep chest open and I will tell something that will make your  
>> blood curdle but has worked well.
>> Apply fresh curds (Yoghurt) to the wound. This will displace the E  
>> coli and the colonized lactobacillus is nonpathogenic ansd will  
>> get eliminated. Later you can mobilize flaps/ close with drains.
>> IV antibiotics after mediastinal cultures etc etc are obvious.
>> Look for diverticulitis especially if a meat eater.
>> erdinç naseri wrote:
>>
>>> Dear forum members,
>>> Opinion requested in the following case:
>>> 76 y/o male applied for CABG and ascending aortic aneurysm(6.5  
>>> cmm at STJ ),No AI.Supracoronary  ascending aortic replacement  
>>> with tubular graft and CABG X 1 one month ago.Had abdominal  
>>> distention at postop 5.th day. No fever.Diagnosed as paralytic  
>>> ileus. stoped oral intake and followed by general surgery guys  
>>> for one week conservatively.WBC 4000 considered normal by them  
>>> but I told them that this is relative neutropenia in open heart  
>>> surgery ( ususally 12-20000 in postop period).After one week  
>>> started oral feeding and discharged.Applied 2 days ago with  
>>> anemia, weakness and abdominal distention.Hospitalized by my  
>>> colleagues and followed medicaly( Genaral surgeons agreed on  
>>> medical follow up),I saw the patient yesterday.No fever with  
>>> Partial dehiscence and wound was dirty( oozing bad smelly  
>>> fluid).Immediately taken to ICU and monitorized.Started  
>>> inotropics for low cardiac out put and took the patient to the  
>>> operation room.Opened the sternum .Very fetid odor and semiclear  
>>> fluid.Grafts intact ,coronary graft open.Deep bradycardia and  
>>> hypotension and arrest followed by mannual massage.Cardiac  
>>> activity returned but with maximum inotropic agents.Opened both  
>>> pleura and put a tube in each and one in suprasternal notch for  
>>> irrigation.He is in ICU  with unremitting fever (39-40)and  
>>> Culture revealed E.coli.
>>> erdinc
>>>
>>>
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>>
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>
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