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Less invasive management of deep neck infection and descending necrotizing mediastinitis: A single-center retrospective study

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TLDR
Transcervical drainage alone is optimal management for all DNI cases and some DNM cases and additional closed thoracic drainage is enough for type I and IIA DNM with pleural effusion or empyema.
About
This article is published in Medicine.The article was published on 2017-04-01 and is currently open access. It has received 17 citations till now. The article focuses on the topics: Mediastinitis & Empyema.

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Citations
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Journal ArticleDOI

Negative Pressure Wound Therapy in the Head and Neck: An Evidence-Based Approach.

TL;DR: To perform an evidence‐based review with recommendations that evaluates the indications and utility of negative pressure wound therapy in the head and neck.
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Multidisciplinary treatment of deep neck infection associated with descending necrotizing mediastinitis: a single-centre experience.

TL;DR: Early diagnosis, proper airway management, and adequate surgical drainage are crucial for reducing mortality in patients with DNM, and minimally invasive procedures also play an important role.
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Microorganisms involved in deep neck infection (DNIs) in Greece: detection, identification and susceptibility to antimicrobials

TL;DR: DNIs represent a medical and surgical emergency and evidence-guided empirical treatment with intravenous infusion of antibiotics at the time of diagnosis is mandatory, highlighting the importance of epidemiological studies regarding the causative microorganisms.
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Management of a difficult infectional disease: Descending necrotizing mediastinitis.

TL;DR: The critical point in the management of DNM is the correct diagnosis, rapid surgical intervention with antibiotherapy and close follow-up for possible complications as the combination of minimally invasive management as VATS-tube thoracostomy with CMD is the most appropriate surgical interventions.
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Management of Descending Necrotizing Mediastinitis, a Severe Complication of Deep Neck Infection, Based on Multidisciplinary Approaches and Departmental Co-Ordination.

TL;DR: Multidisciplinary approaches, early comprehensive medical treatment, and co-ordination among departments significantly reduce mortality in patients with severe inflammation and high CRP levels.
References
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Journal Article

Descending necrotizing mediastinitis.

TL;DR: It is believed that only through aggressive combined medical and surgical management can the highly morbid, if not lethal, course of DNM be reversed.
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Guideline of surgical management based on diffusion of descending necrotizing mediastinitis

TL;DR: Situations where infection has spread to posterior medisatinum, particularly when it reaches in the level of the carina (descending necrotizing mediastinitis-type I), may not always require aggressive mediastinal drainage.
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Descending necrotizing mediastinitis: An analysis of the effects of serial surgical debridement on patient mortality☆☆☆★

TL;DR: An algorithm incorporating computed tomographic imaging for diagnosis and surveillance and serial transcervical and transthoracic operative drainage is outlined in the hope of reducing the excessive mortality of descending necrotizing mediastinitis.
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Descending necrotizing mediastinitis: contemporary trends in etiology, diagnosis, management, and outcome.

TL;DR: Although DNM remains an aggressive infection with high morbidity, a favorable outcome can now be obtained in 85% of patients, even with this selective approach, according to a retrospective study based on the management of 45 patients with DNM.
Journal ArticleDOI

Descending necrotizing mediastinitis: a retrospective surgical experience.

TL;DR: Early diagnosis by CAT scan of the neck and thorax aids in rapid indication of a surgical approach of Descending necrotizing mediastinitis can significantly reduce the mortality rate for this condition to 14%.