Descending Necrotizing Mediastinitis Treated With Rapid Sternotomy Followed by Vacuum-Assisted Therapy Michael Gorlitzer, MD, Martin Grabenwoeger, MD,

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Descending Necrotizing Mediastinitis Treated With Rapid Sternotomy Followed by Vacuum-Assisted Therapy Michael Gorlitzer, MD, Martin Grabenwoeger, MD, Johann Meinhart, PhD, Herwig Swoboda, MD, Wolfgang Oczenski, MD, Nikolaus Fiegl, MD, Ferdinand Waldenberger, MD The Annals of Thoracic Surgery Volume 83, Issue 2, Pages 393-396 (February 2007) DOI: 10.1016/j.athoracsur.2006.09.059 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 A computed tomography scan shows a large descending abscess (arrows) in the visceral fascia, the carotid sheath, and the mediastinum. The Annals of Thoracic Surgery 2007 83, 393-396DOI: (10.1016/j.athoracsur.2006.09.059) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Descending necrotizing mediastinitis with communication between the neck and the upper part of thorax after excessive debridement of the neck and sternotomy. The Annals of Thoracic Surgery 2007 83, 393-396DOI: (10.1016/j.athoracsur.2006.09.059) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Wound sealed with the vacuum-assisted closure system. The Annals of Thoracic Surgery 2007 83, 393-396DOI: (10.1016/j.athoracsur.2006.09.059) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Chest computed tomography scan shows gas collections (arrows) in the anterior and middle compartments of the mediastinum and the aortic wall. The Annals of Thoracic Surgery 2007 83, 393-396DOI: (10.1016/j.athoracsur.2006.09.059) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions