By Alex G. Little MD, Walter H. Merrill MD
Drs. Little and Merrill draw on their services commonly thoracic and cardiac surgical procedure to study tracheobronchial operations, lung quantity aid operations, lung transplantation, minimally invasive esophagectomy, pleural operations, revascularizations, myocardial operations, and aortic and nice vessel operations. for every operation, prime practitioners offer particular suggestion on what to concentrate on to avoid issues -- and the way to regulate them in the event that they do ensue.
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Additional resources for Complications in Cardiothoracic Surgery: Avoidance and Treatment
It requires elevation and dorsal retraction of the latissimus dorsi. The serratus is again split in the direction of its ﬁbers. 6 (a) Dissection and mobilization of the latissimus dorsi muscle so it can be retracted rather than divided. (b) The serratus anterior has been divided in the direction of its ﬁbers to expose the intercostal space. (Reprinted by permission: J Thorac Cardiovasc Surg 1990; 99: 592. ) long thoracic nerve may be vulnerable to injury and a thorough knowledge of its anatomy is necessary.
More recent studies have shown that the routine use of properly administered systemic antibiotics prior to thoracotomy reduces the wound infection rate [99,100]. The timing of the antibiotic administration is important, since delay after inoculation decreases the efﬁcacy. We begin the intravenous antibiotic infusion in the operating room so we are assured that the drug has circulated within 1 h of the thoracic incision. Some authors differentiate between wound infection (well controlled with antibiotics) and other thoracic infections such 30 Chapter 1 as empyema or pneumonia.
A secure closure utilizing the diaphragmatic sutures to close the abdominal and chest wall muscles helps to prevent herniation of abdominal viscera through a weakened area by drawing the diaphragm up to the undersurface of the costal arch . Bilateral thoracosternotomy: the clamshell incision Early cardiac surgery was frequently performed through the thoracosternotomy or clamshell incision. Subsequent conversion to the median sternotomy relegated this incision to the archives, but new indications have surfaced.