Succsessful Wound Treatment with Silver-Containing Carboxymethylated Cellulose （AQUACEL^®Ag） for MRSA Mediastinitis Following Pediatric Open Heart Surgery

Abstract

Recently，negative pressure wound therapy（ NPWT） for the treatment of mediastinitis following open-heart surgery has been frequently used even in a pediatric cohort. The safety and efficacy of NPWT has been reported in an increasing number of studies； however，in cases with hemodynamic instability or tissue fragility in a vacuum，conventional treatment，such as irrigation and packing of the wound，is still an available option. Here we report a one-month-old male infant with methicillineresistant Staphylococcus aureus mediastinitis after palliative repair for double outlet right ventricle and subpulmonary VSD，successfully treated by irrigation and subsequent packing of the wound with silver-containing carboxymethylated cellulose （AQUACEL^®Ag），a material with high absorbability of tissue fluids and antibacterial potential of ionic silver. AQUACEL^®Ag is as good an alternative as packing material after mediastinal irrigation in pediatric patients with fragile tissue due to infection. In addition，treatment of mediastinitis with this method could be the bridging therapy to NPWT while hemodynamic instability or vulnerability of infected tissue is concerned.