초록접수 현황
| 19F-019 | 포스터 발표 |
Successful Management of Foreign Prosthetic Implant Infection in Chest Wall Diseases: 2 Cases
Sung Hwan Kim, Jae Jun Jung, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Joung Hun Byun, Jong Woo Kim
Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Gyeongnam, Republic of Korea
Purpose : We want to share 2 cases with successful management of foreign prosthetic material infection who underwent chest wall surgery.
Methods : One patient with pectus excavatum had Nuss operation. And had to come over ER because of prosthetic infection of Nuss bar. We cultured the discharge and had positive result of gram-positive bacterial infection.
The second patient with chondrosarcoma underwent wide sternal resection and overlying musculocutaneous tissue and reconstruction with bone cement block. After receiving radiotherapy the implanted block stability was deteriorated and had to have reoperation. After the removal of the prosthesis, a metallic implant was applied for re-reconstruction. And several days later the patient had gram-positive bacterial infection.
Results : Both of the patient first had drainage procedure without removal of the prosthesis. Intravenous antibiotics were applied and when the symptoms and infection marker improved, medication could be changed to oral antibiotics. Some duration of medication both of the patients recovered well without removal of foreign prosthetic implant.
Conclusion : Sometimes it is very challenging to treat chest wall disease. Wide resection of the sternal malignancy sometimes needs reconstuction with foreign material and should be kept in place lifelong period. In case of pectus excavatum, Nuss bar should be kept in place for 2 or 3 years. But when infection occurs around the prosthetic material it is a disater for surgeon. Because the surgeon should consider the removal of the prosthesis and reoperation after several months. In selected cases, we could manage it with antibiotics and no additional procedure.
Methods : One patient with pectus excavatum had Nuss operation. And had to come over ER because of prosthetic infection of Nuss bar. We cultured the discharge and had positive result of gram-positive bacterial infection.
The second patient with chondrosarcoma underwent wide sternal resection and overlying musculocutaneous tissue and reconstruction with bone cement block. After receiving radiotherapy the implanted block stability was deteriorated and had to have reoperation. After the removal of the prosthesis, a metallic implant was applied for re-reconstruction. And several days later the patient had gram-positive bacterial infection.
Results : Both of the patient first had drainage procedure without removal of the prosthesis. Intravenous antibiotics were applied and when the symptoms and infection marker improved, medication could be changed to oral antibiotics. Some duration of medication both of the patients recovered well without removal of foreign prosthetic implant.
Conclusion : Sometimes it is very challenging to treat chest wall disease. Wide resection of the sternal malignancy sometimes needs reconstuction with foreign material and should be kept in place lifelong period. In case of pectus excavatum, Nuss bar should be kept in place for 2 or 3 years. But when infection occurs around the prosthetic material it is a disater for surgeon. Because the surgeon should consider the removal of the prosthesis and reoperation after several months. In selected cases, we could manage it with antibiotics and no additional procedure.
책임저자: Sung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Gyeongnam, Republic of Korea
발표자: Sung Hwan Kim, E-mail : dr.sunghwankim@hotmail.com