Hydrogen Solution Treats Heart Surgery Infection with 87% Success Rate

Authors
Journal
The Japanese Journal of Thoracic and Cardiovascular Surgery
Year
DOI
10.1007/s11748-003-0112-6
Study Type
Human
Outcome
Positive
Peer Reviewed
Yes
Country
Japan
Health Condition
Post-sternotomy Mediastinitis
Body System
Cardiovascular

TL;DR

A treatment involving cleaning, draining, and antibiotics was mostly effective for a serious chest infection following heart surgery.

Key Finding

Closed irrigation using alternating povidone-iodine and electrolyzed strong acid aqueous solution resulted in 87.5% survival and prevented recurrent infection in all 7 surviving patients with post-sternotomy mediastinitis.

Summary

This study reviewed 8 cardiac surgery patients who developed mediastinitis (a serious infection in the chest cavity after heart surgery). Doctors treated them with aggressive cleaning of the infected area, followed by closed irrigation and drainage (continuously flushing the wound with liquid while keeping it sealed). They alternated between two solutions: povidone-iodine (a common disinfectant) and electrolyzed strong acid aqueous solution (a specially treated salt water). Seven of the 8 patients survived and remained free of recurrent infection.

Practical Takeaway

This study examined a surgical infection treatment in a hospital setting and does not address hydrogen water as a consumer health product. The electrolyzed solution used was a disinfectant for direct wound irrigation during cardiac surgery, not a beverage. The findings are not applicable to drinking hydrogen water.

Abstract

The aim of this study was to assess the adequacy of our treatment strategy for patients with post-sternotomy mediastinitis. Between May 1997 and December 2000, 1,045 consecutive adult cardiac operations were performed at our center. Mediastinitis occurred in 8 patients (0.77%) and as treatment, they underwent (1) aggressive debridement, (2) closed irrigation and drainage, and (3) transvenous administration of antibiotics. We irrigated the mediastinum with 0.1-1.0% povidone-iodine solution, alternating with electrolyzed strong acid aqueous solution. We subsequently reviewed the outcome after the closed irrigation treatment for patients with post-sternotomy mediastinitis. In four of the 8 patients, the culture specimen grew Methicillin-resistant Staphylococcus aureus. In the others, Serratia marcescens, Staphylococcus epidermidis, Pseudomonas aeruginosa and Gram-negative rods were cultured. The mean period between primary surgery and the diagnosis of mediastinitis was 16.3 (8 -57) days. The mean period between diagnosis of mediastinitis and the start of the irrigation treatment was 0.8 (0-3) days. The mean irrigation period was 30.0 (14-47) days. The irrigation complications were mild hepatic dysfunction in 2 patients, hyponatremia in 2 and protracted wound infection in 1. The hospital mortality was 1/8 (12.5%). Seven survivors are free from recurrent mediastinitis. Our experience of closed irrigation and drainage suggests that it can yield satisfactory results after post-sternotomy mediastinitis, comparable to other reported results with or without muscle flaps.