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Risk factors of infection of implanted device after the Nuss procedure

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Abstract

Purpose

The Nuss procedure is a minimally invasive procedure for the correction of pectus excavatum. It involves insertion of a substernal metal bar. A feared complication of any implantation procedure is infection, which often requires removal of the implanted device. This report describes the authors’ experience with infectious complications after the Nuss procedure.

Methods

The study included 195 patients diagnosed with pectus excavatum. We performed the Nuss procedure under thoracoscopic control on all the patients. Factors analyzed for all patients included bar infection, sex, age, number of bars, and season of the year during which the operation was performed.

Results

Of the 195 study patients, there were 11 patients who suffered postoperative infectious complications, including 7 patients with cellulitis and 4 patients with bar infections. We removed the infected bars from three of the patients with bar infections. Ten of the patients with infected bar had undergone their operations in the summer. Sex, age and number of bars did not differ significantly between patients with or without infections. However, a significantly higher number of infections occurred among patients who underwent the Nuss procedure in the summer compared with the other seasons of the year (P < 0.05, Kruskal–Wallis Test).

Conclusion

All patients with cellulitis successfully recovered with conservative treatment. However, 75 % of the patients with bar infections required removal of the infected device. Our study results showed that performance of the Nuss procedure during summer is a risk factor for postoperative infection. We recommend that particularly careful technique must be used during summer to prevent postoperative infections following the Nuss procedure.

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Authors and Affiliations

  1. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Keiichiro Tanaka, Naruo Kuwashima, Shu-ichi Ashizuka, Jyoji Yoshizawa & Takao Ohki

Authors
  1. Keiichiro Tanaka
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  2. Naruo Kuwashima
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  3. Shu-ichi Ashizuka
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  4. Jyoji Yoshizawa
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  5. Takao Ohki
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Corresponding author

Correspondence to Keiichiro Tanaka.

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Tanaka, K., Kuwashima, N., Ashizuka, Si. et al. Risk factors of infection of implanted device after the Nuss procedure. Pediatr Surg Int 28, 873–876 (2012). https://doi.org/10.1007/s00383-012-3145-z

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  • DOI: https://doi.org/10.1007/s00383-012-3145-z

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