Abstract
BackgroundDeep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Here we first present a case of a patient successfully treated for antibiotic-loaded bone cement (ALBC) combined with vacuum sealing drainage (VSD) of DSWI.Case presentationThis case report presented a patient who underwent open heart surgery, and suffered postoperatively from a DSWI associated with enterococcus cloacae. Focus debridement combined with ALBC filling and VSD was conducted in stage I. Appropriate antibiotics were started according to sensitivity to be continued for 2 weeks until the inflammatory markers decreased to normal. One month after the surgery, patient’s wound was almost healed and was discharged from hospital with a drainage tube. Two months after the stage I surgery procedure, the major step was removing the previous ALBC, and extensive debridement in stage II. The patient fully recovered without further surgical treatment.ConclusionsThe results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.
Highlights
Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience
The results of this case suggest that antibiotic-loaded bone cement (ALBC) combined with vacuum sealing drainage (VSD) may be a viable and safe option for deep sternal wound reconstruction
Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery
Summary
Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of this complication ranges between 1 and 3% [1, 2] and on average mortality of 10–47% [3, 4]. The patient was referred to our center with a 1-week history of abundant discharge accompanied by fever (39.5 °C), painful sternal instability, and shortness of breath He had a purulent wound in the upper part of his sternotomy incision, with a fistula approximately 4 cm long (Fig. 1a). The subcutaneous tissue and bilateral pectoralis major muscle flap were intermittently sutured to cover sternum defect by methods of relieving tension
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