[HSF] anaerobic late mediastinitis

Mon Mar 26 21:02:56 EDT 2007

Yes I have done it.
It is described also in general surgery books.
Prasanna

On 3/25/07, Michael Firstenberg <msfirst at gmail.com> wrote:
>
> 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
> >>>>
> >>>>
> >>>> _______________________________________________
> >>>> OpenHeart-L mailing list
> >>>>
> >>>> Send postings to:
> >>>> OpenHeart-L at lists.hsforum.com
> >>>>
> >>>> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >>>> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>>>
> >>>> All messages transmitted by the OpenHeart-L are subject to the
> >>>> policies and disclaimers posted at:
> >>>> http://www.hsforum.com/listdisclaim
> >>>> -----------------------------------------
> >>>>
> >>>>
> >>>>
> >>>
> >>> _______________________________________________
> >>> OpenHeart-L mailing list
> >>>
> >>> Send postings to:
> >>>  OpenHeart-L at lists.hsforum.com
> >>>
> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >>> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>>
> >>> All messages transmitted by the OpenHeart-L are subject to the
> >>> policies and disclaimers posted at:
> >>> http://www.hsforum.com/listdisclaim
> >>> -----------------------------------------
> >>>
> >>> _______________________________________________
> >>> OpenHeart-L mailing list
> >>>
> >>> Send postings to:
> >>>  OpenHeart-L at lists.hsforum.com
> >>>
> >>> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >>> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>>
> >>> All messages transmitted by the OpenHeart-L are subject to the
> >>> policies and disclaimers posted at:
> >>> http://www.hsforum.com/listdisclaim
> >>> -----------------------------------------
> >>>
> >>>
> >>>
> >>
> >> _______________________________________________
> >> OpenHeart-L mailing list
> >>
> >> Send postings to:
> >> OpenHeart-L at lists.hsforum.com
> >>
> >> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> >> http://mmp.cjp.com/mailman/listinfo/openheart-l
> >>
> >> All messages transmitted by the OpenHeart-L are subject to the
> >> policies and disclaimers posted at:
> >> http://www.hsforum.com/listdisclaim
> >> -----------------------------------------
> > _______________________________________________
> > OpenHeart-L mailing list
> >
> > Send postings to:
> > OpenHeart-L at lists.hsforum.com
> >
> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> > http://mmp.cjp.com/mailman/listinfo/openheart-l
> >
> > All messages transmitted by the OpenHeart-L are subject to the
> > policies and
> > disclaimers posted at:
> > http://www.hsforum.com/listdisclaim
> > -----------------------------------------
>
> _______________________________________________
> OpenHeart-L mailing list
>
> Send postings to:
> OpenHeart-L at lists.hsforum.com
>
> To UNSUBSCRIBE, to CHANGE email address, or to view archives:
> http://mmp.cjp.com/mailman/listinfo/openheart-l
>
> All messages transmitted by the OpenHeart-L are subject to the policies
> and
> disclaimers posted at:
> http://www.hsforum.com/listdisclaim
> -----------------------------------------
>

-- 
Prasanna Simha M