Treatment of irradiated poststernotomy sternal nonunion with autologous stem cell–impregnated bone matrix and sternal plating

Abstract

Sternal wound complications are an infrequent but significant cause of postoperative morbidity for cardiothoracic surgical patients. Sternal nonunion occurs in fewer than 1% of patients after median sternotomy, but it represents a challenging clinical problem because it is often associated with chronic pain of debilitating magnitude. Affected patients are often treated with debridement and sternal rewiring, which requires reexploration of the mediastinum. We describe the case of a patient successfully treated with an autologous stem cell–seeded bone matrix and sternal plating for chronic manubrial nonunion in a postsurgical, irradiated sternum.