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Published: 2025-03-24
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DOI: https://doi.org/10.52163/yhc.v66iCĐ2.2186
Issue
Vol. 66 No. CĐ2
Section
Articles
How to Cite
Vỹ, T. T. (2025). 3. POSTOPERATIVE INFECTIOUS COMPLICATIONS AFTER NUSS PROCEDURE FOR PECTUS EXCAVATUM REPAIR. Vietnam Journal of Community Medicine, 66(CĐ2). https://doi.org/10.52163/yhc.v66iCĐ2.2186

3. POSTOPERATIVE INFECTIOUS COMPLICATIONS AFTER NUSS PROCEDURE FOR PECTUS EXCAVATUM REPAIR

Tran Thanh Vy1,2
1 Thoracic and Vascular Department, University Medical Center Ho Chi Minh city
2 Department of Thoracic and Cardiovascular Surgery, University of Medicine and Pharmacy at Ho Chi Minh city

Main Article Content

Abstract

Objective: To describe the clinical and paraclinical characteristics in patients with infections following the Nuss procedure for pectus excavatum.


Method: A retrospective case series study was conducted at the University Medical Center Ho Chi Minh city. Data were collected from 21 patients diagnosed with bar infections after the Nuss procedure between January 2019 and May 2024. Clinical features, surgical details, and infection management were analyzed.


Results: The average patient age was 16.14 ± 4.93 years, with 71.4% being male. Asymmetric chest deformity was present in 71.4% of cases, and 85.7% underwent double-bar placement. Common infection symptoms included localized erythema (100%), purulent discharge (71.4%), chest pain (71.4%), and fever (66.7%). The average time to infection onset was 4.00 ± 5.05 months postoperatively. Deep bar infections occurred in 14.3% of cases, with one patient requiring early bar removal. Identified pathogens included Staphylococcus epidermidis and Staphylococcus aureus. Treatment mainly involved oral antibiotics, with some cases requiring abscess drainage or wound debridement.


Conclusions: Infections following the Nuss procedure are a challenging complication requiring early detection and timely intervention. Identifying risk factors, optimizing surgical techniques, and ensuring strict infection control measures are essential to reducing this complication.

Article Details

Keywords

Pectus excavatum, Nuss procedure, bar infection

References

[1] Nuss D, Kelly R.E, Croitoru D.P, Katz M.E, A 10-year review of a minimally invasive technique for the correction of pectus excavatum, J Pediatr Surg, 1998 Apr, 33 (4): 545-52.
[2] Shin S, Goretsky M.J, Kelly R.E et al, Infectious complications after the Nuss repair in a series of 863 patients, J Pediatr Surg, 2007, 42 (1): 87-92.
[3] Obermeyer R.J, Godbout E, Goretsky M.J et al, Risk factors and management of Nuss bar infections in 1717 patients over 25 years, J Pediatr Surg, 2016, 51 (1): 154-158.
[4] Castellani C, Schalamon J, Saxena A.K, Hoellwarth M.E, Early complications of the Nuss procedure for pectus excavatum: A prospective study, Pediatr Surg Int, 2008, 24 (6): 659-666.
[5] Calkins C.M, Shew S.B, Sharp R.J et al, Management of postoperative infections after the minimally invasive pectus excavatum repair, J Pediatr Surg, 2005, 40 (6): 1004-1008.
[6] Phạm Hữu Lư, Vũ Văn Bộ, Biến chứng của kỹ thuật phẫu thuật Nuss cải tiến trong điều trị lõm ngực bẩm sinh, Tạp chí Y học Việt Nam, 2022, 512 (2): 236-239.
[7] Nguyễn Việt Anh, Mạc Thế Trường, Phạm Hữu Lư, Nguyễn Hữu Ước, Kết quả điều trị lõm ngực bằng phẫu thuật Nuss cải tiến tại Bệnh viện Việt Đức, Tạp chí điện tử Phẫu thuật Tim mạch và Lồng ngực Việt Nam, 2018, 22: 75-81.
[8] Obermeyer R.J, Cohen N.S, Gaffar S et al, Multivariate analysis of risk factors for Nuss bar infections: A single center study, J Pediatr Surg, 2018, 53 (6): 1226-1229.
[9] Lowy Franklin D: Staphylococcus aureus Infections, New England Journal of Medicine, 339: 520-532.
[10] Vuong C, Otto M: Staphylococcus epidermidis infections, Microbes and Infection, 2002, 4: 481-489, 10.1016/S1286-4579(02)01563-0.