Treatment of chronic purulent sternomediastinitis with physioprocedures based on ultraviolet and laser irradiation

Purulent sternomediastinitis is a severe complication of open cardiac surgery. Although the incidence of postoperative sternomediastinitis is 1-3%, mortality from this condition is high, and its course is complicated by concomitant diseases. In addition, the effectiveness of treatment of purulent sternomediastinitis varies depending on the approach used, and is also determined by the individual characteristics of the patient. A clinical case of successful treatment of chronic purulent-destructive sternomediastinitis in a 53-year-old patient, which developed after aortocoronary bypass surgery from a sternotomy approach and lasted for one year, is presented. Physiotherapy procedures based on ultraviolet irradiation, laser therapy and intravenous laser blood irradiation in combination with antibacterial therapy were used for treatment, since there was prolonged suppuration of the wound in the postoperative period. The characteristics and sequence of the applied effects during the procedures are described in detail. After three courses of combined physiotherapy procedures, the patient's wound was cleared of pathogenic microflora, suppuration ceased, swelling and wound size decreased, and the wound healed. The results obtained in this study show that the combined use of ultraviolet irradiation, laser therapy and intravenous laser blood irradiation leads to rapid healing of the sternum wound in the treatment of complex purulent-destructive sternomediastinitis. The effectiveness and advantages of such combined physiotherapy procedures over invasive treatment methods should be studied in more detail.