scholarly journals Sternal osteomyelitis and costochondritis after median sternotomy

1973 ◽  
Vol 65 (2) ◽  
pp. 227-233 ◽  
Author(s):  
T.M. Wray ◽  
R.E. Bryant ◽  
D.A. Killen
1984 ◽  
Vol 33 (2) ◽  
pp. 541-547
Author(s):  
Katsuji Shimizu ◽  
Goro Awaya ◽  
Fumihide Matsuda ◽  
Shigeaki Wakita ◽  
Masaki Maekawa ◽  
...  

2014 ◽  
Vol 20 (9) ◽  
pp. 574-576 ◽  
Author(s):  
Yoon T. Chin ◽  
Monica Krishnan ◽  
Phillipa Burns ◽  
Ahmed Qamruddin ◽  
Ragheb Hasan ◽  
...  

2014 ◽  
Vol 95 (6) ◽  
pp. 811-816 ◽  
Author(s):  
M V Shvedova ◽  
G Ts Dambaev ◽  
A N Vusik ◽  
V M Gulyaev

Aim. To assess the results of treatment in patients with deep postoperative complications after median sternotomy. Methods. The study included 33 patients: 25 males and 8 females (mean age 58.63±6.29 and 60.3±12.9 years, respectively). X-ray, helical computed tomography of the chest, sternum and anterior mediastinum ultrasound, echocardiography, pulmonary function test, bacteriology, clinical and laboratory tests were used to assess pre- and post-operative conditions of the patients. Fistulography and sternum scintigraphy with 99mTc-technetril were performed if necessary. Complications included anterior mediastinitis, sternal osteomyelitis, sternal diastasis, chest bones instability and sternal fragmentation. Some patients also developed superficial wound infection together with internal complications. The first stage of treatment included secondary surgical debridement, metal suture osteosynthesis, surgical sternal reconstruction by titanium nickelide plexiform tubulous implant and VRAM flap thoracomyoplasty. Results. Secondary surgical debridement was performed as the first stage of treatment in 51.51% patients (n=17) including 29.4% patients who were operated for the second time. Metal suture osteosynthesis as step 1 surgery was performed in 33.3% of patients (n=11); 54.5% of patients (n=6) were re-operated. Metal suture or clamp osteosynthesis did not lead to the sternal reconstruction in 80% of cases. Chest surgical reconstruction by titanium nickelide implants as step 1 surgery was performed in 12.12% of patients (n=4) resulting in chest stabilization, sternal diastasis elimination, and correction of sterno-mediastinitis. VRAM flap thoracomyoplasty was performed in 1 patient. Conclusions. The step-wise approach surgery was preferable (step 1 - secondary surgical debridement and antibiotics, step 2 - surgical sternal reconstruction). Sternal reconstruction by titanium nickelide implants is indicated for treating patients without severe sternal fragmentation and offers good early results.


2008 ◽  
Vol 62 (6) ◽  
pp. 1339-1343 ◽  
Author(s):  
Yoav Barnea ◽  
Yehuda Carmeli ◽  
Boris Kuzmenko ◽  
Shiri Navon-Venezia

2007 ◽  
Vol 119 (2) ◽  
pp. 568-572 ◽  
Author(s):  
Alexander M. Spiess ◽  
Tanju Istanbullu ◽  
Patricia D. Brown ◽  
Chenicheri Balakrishnan ◽  
Eti Gursel

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Petros Konofaos ◽  
Eleftherios Spartalis ◽  
Grigorios Karagkiouzis ◽  
Christos Kampolis ◽  
Periklis Tomos

Introduction.Sternal osteomyelitis with or without mediastinal infection is a severe and rare complication of median sternotomy. In this paper, an alternative technique for the reconstruction of sternal defects with the use of bilateral pectoralis major pedicled muscle flaps is presented.Case presentation.A 70-year-old man with the diagnosis of poststernotomy osteomyelitis underwent reconstruction of his sternal defect with the use of bilateral pectoralis major muscle flaps. The patient had an uneventful recovery, and the physical examination revealed a normal range of motion for both upper limbs and sternal stability.Conclusion.The proposed technique incorporates a simple mobilization of the two pectoralis major muscles to be used as flaps to fill the sternal defect without the need for humeral detachment or a second cutaneous incision. Using this technique, a muscular implant is made that seals the dead space, which has no tension due to the presence of a second layer. Postoperative results are excellent, not only regarding infection and functionality but also from an aesthetic point of view.


Author(s):  
CL Hastings ◽  
RD Carlton ◽  
FG Lightfoot ◽  
AF Tryka

The earliest ultrastructural manifestation of hypoxic cell injury is the presence of intracellular edema. Does this intracellular edema affect the ability to cryopreserve intact myocardium? To answer this guestion, a model for anoxia induced intracellular edema (IE) was designed based on clinical intraoperative myocardial preservation protocol. The aortas of 250 gm male Sprague-Dawley rats were cannulated and a retrograde flush of Plegisol at 8°C was infused over 90 sec. The hearts were excised and placed in a 28°C bath of Lactated Ringers for 1 h. The left ventricular free wall was then sliced and the myocardium was slam frozen. Control rats (C) were anesthetized, the hearts approached by median sternotomy, and the left ventricular free wall frozen in situ immediately after slicing. The slam frozen samples were obtained utilizing the DDK PS1000, which was precooled to -185°C in liguid nitrogen. The tissue was in contact with the metal mirror for a dwell time of 20 sec, and stored in liguid nitrogen until freeze dry processing (Lightfoot, 1990).


VASA ◽  
2008 ◽  
Vol 37 (3) ◽  
pp. 293-296 ◽  
Author(s):  
Akgun ◽  
Ak ◽  
Tugrular ◽  
Civelek ◽  
Isbir ◽  
...  

Cuffed tunneled venous access catheters are commonly used for temporary and permanent access in patients undergoing hemodialysis. These catheters play an essential role in providing permanent access in patients in whom all other access options have been exhausted. However, they are prone to several complications like catheter thrombosis, catheter fibrin sheating and infection. Herein, we report two uncommon cases of stuck hemodialysis cuffed tunneled catheters causing stenosis and thrombosis in central veins which needed to be removed by median sternotomy.


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