[HSF] anaerobic late mediastinitis

[Michael Firstenberg]

I recall in an older version of Glenn's they talk about pouring sugar  
into an open chest.  I had a mentor who advocated it's use - but  
never saw it myself.... the concept is creating a hyper-osmolar  
environment which would be toxic to the bacteria - some logic into.


-michael




On Mar 23, 2007, at 4:11 PM, Donald Ross wrote:

> 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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