Definitive closure of the infected median sternotomy wound: A treatment algorithm utilizing vacuum-assisted closure followed by rigid plate fixation

Sara R. Dickie, Amir H. Dorafshar, David H. Song

Research output: Contribution to journalArticle

Abstract

Mediastinitis and sternal wound dehiscence are devastating and life-threatening complications of median sternotomy incision. Ten consecutive patients between July 2001 and May 2005 were diagnosed with sternal wound infection and dehiscence following median sternotomy. Patients were managed by precise debridement and wound excision in the operating room and then dressed with vacuum-assisted closure device. Intravenous antibiotics were prescribed for wound and blood culture microbiological sensitivity. When wounds were bacteriologically controlled, patients returned to the operating room for definitive closure using rigid sternal plating. All patients were extubated postoperatively. No patients died. Average total hospital stay was 21 days. The pectoralis advancement flap was exclusively used for soft tissue reconstruction in 7 patients. There were 2 cases of chronic superficial sternal infection requiring plate removal; however, bony union of the sternum was achieved in all patients. This treatment algorithm provides a useful management strategy for patients with complicated median sternotomy.

Original languageEnglish (US)
Pages (from-to)680-685
Number of pages6
JournalAnnals of plastic surgery
Volume56
Issue number6
DOIs
StatePublished - Jun 1 2006

Keywords

  • Mediastinitis
  • Rigid sternal fixation
  • Sternal plate
  • Sternal wound dehiscence
  • Sternal wound reconstruction
  • VAC

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Definitive closure of the infected median sternotomy wound: A treatment algorithm utilizing vacuum-assisted closure followed by rigid plate fixation'. Together they form a unique fingerprint.

  • Cite this