Deep sternal wound infection after open heart surgery: current treatment insights. A retrospective study of 36 cases
作者： Rutger M. Schols , Thomas M. A. S. Lauwers , Gijs G. Geskes , René R. W. J. van der Hulst
DOI: 10.1007/S00238-011-0573-2
关键词: Artery 、 Reconstructive surgery 、 Sternum 、 Surgery 、 Cardiothoracic surgery 、 Plastic surgery 、 Refixation 、 Medicine 、 Retrospective cohort study 、 Wound dehiscence
摘要: The aim of this study was to retrospectively evaluate the results reconstructing infected post-sternotomy wounds, with either sternal plating and/or pectoralis major flap transposition or pedicled omentoplasty after previous vacuum-assisted closure (VAC) therapy. Between January 2005 and December 2010, 36 patients, suffering from deep wound infection (DSWI) coronary artery bypass grafting procedure, received (plastic) reconstructive surgery. All treated in Maastricht University Medical Centre (Departments Plastic Surgery Cardiothoracic Surgery), were selected for study. For 22 refixation reconstruction obtained by internal plate fixation combined bilateral advancement flap. In 11 a performed, without split-skin graft additional VAC Three patients only plasty. We evaluated preoperative characteristics post-operative course. Twenty-four (66.7%) had an uneventful Complications other included dehiscence, herniation donor site material. Average healing plus plasty, plasty respectively accounted 7.7, 8.0 11.6 weeks. From our experience, we recommend therapy delayed as first repair option case DSWI. However, individual clinical conditions need be taken into account when making decision between different available options. Omentoplasty should reserved cases which sternum has recurrently fallen open refixation, defect is too extended.
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