Current Treatment for Mediastinitis.

Çağatay Çetinkaya, Hasan Fevzi Batirel

Journal: Thoracic surgery clinics 2026;36(3):337-349

PMID: 42336512

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Abstract

Mediastinitis remains a life-threatening infection that requires rapid, imaging-guided diagnosis and decisive source control. This article analyzes and compiles the current, evidence-based management across major etiologies of mediastinitis descending cervicothoracic infections, esophageal leak/perforation, and poststernotomy infection, emphasizing antimicrobial treatment, timely drainage and debridement, chest wall stabilization and vascularized coverage when indicated, and the judicious use of negative-pressure wound therapy as a bridge to final closure. Practical, evidence based pathways are outlined to determine access and reconstruction, alongside key points on nutrition, antifungal strategy, and short-interval reassessment to optimize outcomes.

Address: Department of Thoracic Surgery, Uskudar University School of Medicine, Istanbul, Turkiye.; Department of Thoracic Surgery, Biruni University School of Medicine, Istanbul, Turkiye. Electronic address: [email protected].

DOI: 10.1016/j.thorsurg.2026.02.012

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MeSH Terms: Humans, Mediastinitis, Surgical Wound Infection, Drainage, Debridement, Negative-Pressure Wound Therapy