Negative-pressure wound therapy and laparoscopic omentoplasty for deep sternal wound infections after median sternotomy.

摘要: Deep sternal wound infection remains one of the most serious complications in patients who undergo median sternotomy for coronary artery bypass surgery. We describe our experience treating 6 consecutive with treatment protocol that combines aggressive debridement, broad-spectrum antibiotics, negative-pressure therapy, omentoplasty laparoscopically harvested omentum, and use bilateral pectoral muscle advancement flaps. The number debridements needed order to attain clinically clean wounds negative cultures varied between 1 10, a 5. The length stay after flap placement 11 22 days. One developed small dehiscence was treated conservatively. No bleeding related vacuum-assisted closure therapy identified. Three had pneumonia. Two 3 an episode acute renal failure. 30-day mortality rate zero, although patient died hospital 43 days reconstructive surgery, multiple-organ failure due pneumonia induced by end-stage pulmonary fibrosis. discharge recent follow-up date (4–12 mo). Late local results, both functional aesthetic, were good. We conclude therapy—in combination using omentum flaps—is valuable technique deep because it produces good aesthetic results.