scholarly journals Management of Deep Sternal Wound Infection: Complete Sternal Osteomyelitis

2020 ◽  
Vol 23 (3) ◽  
pp. E281-E284
Author(s):  
Khaled Ebrahim Al-Ebrahim
Keyword(s):  
Cardiac Surgery ◽  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Rectus Abdominis ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Therapy ◽  
Rectus Abdominis Flap ◽  
Sternal Osteomyelitis

Deep sternal wound infection (DSWI) after cardiac surgery is a challenging complication that affects the outcome of surgery. The worst type of DSWI is mediastinitis and sternal osteomyelitis, which dramatically increase morbidity, mortality, and cost of care. This case report describes successful treatment of sternal osteomyelitis after open heart surgery with combined negative pressure wound therapy and rectus abdominis flap. This combination of negative pressure wound therapy with rectus abdominis flap in treating sternal osteomyelitis after open cardiac surgery is not well studied.

Negative Pressure Wound Therapy in Poststernotomy Deep Sternal Wound Infection

2016 ◽  
pp. 41-73
Author(s):  
Christian Willy ◽  
Catharina Scheuermann-Poley ◽  
Marcus Stichling ◽  
Onnen Grauhan ◽  
André Lieber
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Therapy

scholarly journals Decreasing complications of pectoralis major muscle flap reconstruction with two modalities of negative pressure wound therapy

2021 ◽  
pp. 145749692110433
Author(s):  
Heidi-Mari Myllykangas ◽  
Jari Halonen ◽  
Annastiina Husso ◽  
Leena T. Berg
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Pectoralis Major Muscle ◽  
Muscle Flap ◽  
Pectoralis Major ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Therapy ◽  
Pectoralis Major Muscle Flap

Background and objective: Deep sternal wound infection is a feared complication of open-heart surgery. Negative pressure wound therapy has gained an important role in the treatment of deep sternal wound infection. Incisional negative pressure wound therapy has been introduced as a method to prevent wound complications after sternotomy, and lately, after flap reconstructions in the treatment of deep sternal wound infection. We aimed to study if incisional negative pressure wound therapy with PICO™ had similar beneficial effect described earlier with competing commercial devices. Methods: This study included 82 patients treated with pectoralis major muscle flap for deep sternal wound infection during the years 2006–2020. PICO group consisted of 24 patients treated with preoperative negative pressure wound therapy and postoperative incisional negative pressure wound therapy (PICO™). Two control groups included 48 patients with conventional treatment and 10 patients with preoperative negative pressure wound therapy only. Results: In the PICO group, the complication rate declined from 50.0% to 33.30%, major complication rate from 29.2% to 12.5%, and need for an additional flap from 14.6.% to 4.2% when compared to conventional treatment. The length of hospital stay decreased as well. Preoperative negative pressure wound therapy alone was associated with moderate decline in the complication rates. In addition, we described the use of split pectoralis major muscle flap reconstruction in 57 patients. To our knowledge, this is the largest published patient series describing this method in the treatment of deep sternal wound infection. Conclusions: Incisional negative pressure wound therapy with PICO™ seems beneficial after flap reconstruction. Split pectoralis major muscle flap is a versatile reconstruction option suitable to be used as a workhorse in the treatment of deep sternal wound infection.

scholarly journals Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

2013 ◽  
Vol 16 (2) ◽  
pp. 115-119
Author(s):  
Cemalettin Aydın ◽  
Halil Başel ◽  
İbrahim Kara ◽  
Yasin Ay ◽  
Murat Songur ◽  
...  
Keyword(s):  
Wound Infection ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Deep Sternal Wound Infection ◽  
Open Heart ◽  
Sternal Wound Infection ◽  
Wound Therapy

scholarly journals A comprehensive surgical approach to the treatment of deep sternal wound infection after heart transplantation

2021 ◽  
Vol 23 (2) ◽  
pp. 67-75
Author(s):  
V. M. Zakharevich ◽  
V. A. Mitish ◽  
T. A. Khalilulin ◽  
A. R. Zakiryanov ◽  
D. S. Ivanov ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Transplantation ◽  
Wound Infection ◽  
Chest Wall ◽  
Surgical Techniques ◽  
Anterior Chest Wall ◽  
Deep Sternal Wound Infection ◽  
Sternal Wound Infection ◽  
Wound Debridement ◽  
Sternal Osteomyelitis

Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general population ranges from 0.5 to 4% [2, 3]. Despite developed approaches in the treatment of cardiac surgery patients, the treatment of deep sternal wound infection and surrounding tissues following a heart transplantation still remains a rather serious and pressing challenge. This paper presents a clinical observation of a heart transplant recipient, complicated by deep postoperative wound infection. The strategy of staged surgical treatment of sternal osteomyelitis consisted of surgical wound debridement, local wound debridement with vacuum dressings, and reconstructive surgery at the final stage (sternal reosteosynthesis, plasty of the anterior chest wall wound with displaced skin and fascial flaps).

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