Retrospective Analysis of Flap Based Management in Deep Sternal Wound Infection in a Tertiary Care Centre –A Single Centre Study

Abstract

Aims: In this retrospective study we analyzed the outcomes of flap based management in deep sternal wound infection (DSWI). Materials & Methods: Patients, who had undergone open heart surgery through median sternotomy between September 2017 and March 2020 and had developed deep sternal infections, were retrospectively analyzed in this study. Few patients found to have DSWI were managed only by Negative Pressure Wound Therapy (NPWT) and few were managed by NPWT and Bipectoral musculo fascial flap cover. The outcomes in terms of mortality and readmission in the postoperative course were obtained from the records during subsequent follow ups in OPD for six months. Results: Out of 925 patients 11 patients (1.2%) had deep sternal wound infection There were six patients (n=6, 54.55%) who received NPWT where as five patients (n=5, 45.45 %) received flap surgery following NPWT. The patient who underwent Flap surgery had a longer postoperative stay than NPWT group (46.2+/- 22.21, C.I 95%) days Vs (25.5+/- 14.41, C.I 95%) days. However, the readmission due to recurrence of infection was seen only in NPWT group (n=3, 50%) with in the period of six months following discharge. One patient out of the three readmitted patients expired due to sepsis. Conclusion: NPWT followed by bipectoral muscle flap closure has a better surgical outcome than NPW alone in deep sternal wound infection in early postoperative period