Introduction.Mediastinitis has been reported to complicate 5% of sternotomy surgery.We have adopted an open reduction and rigid\r\ninternal fixation (ORIF) approach during the conventional rescue surgery in the treatment of mediastinitis. Methods.Aretrospective\r\nreview was performed to compare the outcomes of patients that had an ORIF to correct postoperative mediastinitis following\r\nmedian sternotomy.These were compared with the outcome of the patients that did not undergo ORIF. Results. In the 5-year study\r\nperiod, we reviewed 35 mediastinitis patient charts. Postoperatively, the ORIF patient group remained in the Intensive Care Unit\r\n(ICU) and on a ventilator for a mean of 1.5 and 0.75 days, respectively. Patients treated without ORIF spent significantly more days\r\nin the ICU (mean of 7.5 days, P < 0.05) and on a ventilator (mean of 2.15 days, P = 0.1). Furthermore, it was found that none of the\r\npatients (0%) who underwentORIF complained of any postoperative sternal instability or pain. Preoperatively, however, these rates\r\nwere as high as 72%. Conclusions. In the select patient, ORIF can be a safe option in the management of mediastinitis, which we\r\nhave shown to significantly decrease morbidity and mortality by providing anatomic reduction as well as physiologic stabilization.\r\nWe have shown that ORIF will improve the quality of life of the patient by minimizing abnormal sternal mobility and pain and will\r\nalso decrease inpatient costs by decreasing days spent in the ICU and ventilator dependence.
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