CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds.

Abstract

We examined the use of CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds. Deep wound infection after median sternotomy is infrequent (1% to 5% of all cases) but is associated with significant morbidity, mortality, and cost. Twenty-four consecutive patients with median sternotomy wound infection were treated by one plastic surgeon using a CO2 laser to sterilize wounds after debridement and before flap closure. The rectus abdominis muscle flap was primarily used, but the choice of muscle flap was case dependent. To date, no patient in this series has had postoperative wound infection, breakdown, or flap loss. One patient did have superficial skin loss. Although the morbidity rate was 17%, all patients had intact wounds. None of the 5 deaths was related to wound infection. We found that CO2 laser sterilization in the surgical treatment of sternal wound infections decreased morbidity, mortality, and cost.