Abstract

Results A consultant non cardiac thoracic surgeon managed 146 patients with DSWI and /or dehiscence. Nine patients were excluded due to sternal dehiscence with no evidence of gross infection and also negative wound culture. Eighty four patients were female. According to El Oakley classification, Type I, II, III, IV, V were 8, 2, 79,5,43, consequently. All patients evaluated by CT scan before intervention or after 1st operation. Patients had soft tissue debridement, with removal of wires in one or staged operation combined with mediastinotomy, mediastinal irrigation and debridement. Twelve patients had near total sternectomy, one upper sternectomy and one patient had sternoclavicular joint resection. One hundred four patient had partial sternectomy (74 longitudinal and 30 transverse sternectomy. Chondrectomy was done in 44 and decortication in 6. Twelve patient had rewiring. Bone stabilization was done by Zipfix or Sternal band +/_ wires in 12 and Titanium plate in 6. Only two patients had negative pressure wound therapy (NPWT) as a bridge to reconstruction. At the end 20 patients had delay simple closure of skin. In 113 patients a total of 163 pectoral muscle flap including: 36 right pectoral major muscle turnover flap (RPMMTF); 53 combined RPMMTF plus left advancement pectoral muscle flap (LTPMMFC); 14 local right or left PMMF were done. We used 4 rectus abdominis flap, 2 omental flap, and breast flap. Twenty nine patients had reoperation after reconstruction. Nine had recurrence osteomyelitis and /or chondritis. One patient had mediastinitis and 9 had skin flap necrosis. Remnant of pace wire was the cause of recurrent infection in 2. Five patients had rewiring or reconstruction and one patient had operation due to GI bleeding. Hospital mortality rate was 8.21% (12 patients were died. Patients had followed for a mean of 40.3 months and 3 years mortality rate was 13.69%.

Highlights

  • Aims/Objective Sternal osteomyelitis and post sternotomy mediastinitis still stays as a severe life-threatening complication after cardiac surgery

  • All patients evaluated by CT scan before intervention or after 1st operation

  • Patients had soft tissue debridement, with removal of wires in one or staged operation combined with mediastinotomy, mediastinal irrigation and debridement

Read more

Summary

Introduction

Aims/Objective Sternal osteomyelitis and post sternotomy mediastinitis still stays as a severe life-threatening complication after cardiac surgery. Surgical management of Sternal wound infection post cardiac surgery “single surgeon experience” From World Society of Cardiothoracic Surgeons 25th Anniversary Congress, Edinburgh Edinburgh, UK. This study was conducted to evaluate the short and long term results of surgical management of deep sternal wounds infection (DSWI). Methods A retrospective study was conducted to investigate post cardiac surgery patients with sternal wound infection by thoracic surgeon.

Results
Conclusion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.