Less Invasive Management of Tissue Deficits for Deep Sternal Wound Infections

BACKGROUND:The frequency of sternomyelitis after cardiovascular surgery has been reported to be 0.4% -5%. METHODS:The treatment method used for 47 patients (29 male and 18 female) who developed sternomyelitis after sternotomy with tissue defects in the chest was examined retrospectively. RESULTS:Of...

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Veröffentlicht in:Plastic and reconstructive surgery. Global open 2020-04, Vol.8 (4), p.e2776-e2776
Hauptverfasser: Watanabe, Hidetaka, Uemura, Tetsuji, Yanai, Tetsu, Kurokawa, Masato, Harada, Yoshimi, Ishihara, Yasuhiro, Chuman, Takahiro, Kawano, Hiroshige
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Sprache:eng
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Zusammenfassung:BACKGROUND:The frequency of sternomyelitis after cardiovascular surgery has been reported to be 0.4% -5%. METHODS:The treatment method used for 47 patients (29 male and 18 female) who developed sternomyelitis after sternotomy with tissue defects in the chest was examined retrospectively. RESULTS:Of the original conditions, the most frequent was coronary artery disease undergoing bypass grafting (22 cases, 46.8%), followed by acute aortic dissection (10 cases, 21.3%). The number of times debridement was performed wasonce, 35 cases; twice, 11 cases; 7 times, 1 case; and unknown, 2 cases. The most frequent time of occurrence of sternomyelitis was within 2 weeks after surgery (12 patients, 25.5%). A residual internal thoracic artery remained on both sides in 28 cases (59.6%), and only on the right side in 17 cases (36.2%); there was no remaining one in 2 cases (4.2%). The reconstruction method was a pectoralis major musculocutaneous flap in 31 cases (66.0%), internal mammary artery perforator flap in 7 cases (14.9%), rectus abdominis musculocutaneous flap in 4 cases (8.5%), omentum transplant in 3 cases (6.4%), superior epigastric artery perforator flap in 2 cases (4.3%), external abdominal oblique muscle flap in 1 case (2.1%), and latissimus dorsi musculocutaneous flap in 1 case (2.1%). The internal mammary artery perforator flap and the superior epigastric artery perforator flap have been effective treatment. CONCLUSIONS:In 47 patients, our method of treatment for tissue defects of the chest wall after sternal osteomyelitis was examined, and an algorithm using less invasive management was proposed.
ISSN:2169-7574
2169-7574
DOI:10.1097/GOX.0000000000002776