Recomendações baseadas em evidências para tratamento de mediastinite pós-cirurgia cardíaca pós esternotomia mediana

Abstract

Introduction: Cardiovascular diseases have a great impact on Public Health. Cardiac surgeries are considered major surgeries due to their complexity. One postoperative complication is mediastinitis, what has a great impact on mortality rates and treatment costs. Objective: To analyze, in scientific literature, interventions for mmediastinitis based on evidence. Method: Integrative literature review. controled and uncontroled descriptors were used, both in English and Portuguese database: Medline via Pubmed, CINAHL, LILACS and Biblioteca Virtual em Saúde.The main question is: Which are the best therapy interventions and more effective treatment for mediastinitis in patients submitted to a cardiac surgery after sternotomy median? Results: Were included in the studies of eight articles, in English, published in North-American, European and Asian magazines. The negative pressure therapy was found in most of studies as the most recommended therapy for patients with stet all lesions and diagnosed with mediastinitis, associated or not with the antibiotical therapy and reconstructive surgery. The scientific evidence is not yet conclusive. Conclusion: The use of negative pressure therapy was shown to be effective for the treatment of mediastinitis compared to conventional covers. New studies should be carried in order to make basis for the propaedeutic.