Omental Pedicle Grafting in the Treatment of Postcardiotomy Sternotomy Infection

摘要: • Postcardiotomy sternal infection occurred in 20 (2%) of 1007 patients undergoing cardiac surgery between September 1985 and December 1987, a 10-fold increase over the preceding 33 months (4 [0.24%] 1627 patients). Cultures were sterile 5 yielded staphylococci 12 variety bowel organisms 3. The cause for increased occurrence wound is unclear after multivariate analysis, although infections have precipitously dropped subsequent to changing cefuroxime sodium antibiotic prophylaxis. Treatment has evolved appropriate antibiotics early debridement involved sternum cartilage. Rewiring not attempted. If gross purulence present, primary closure accomplished using muscle flaps (2 patients) or omental pedicle grafts (17 In presence purulence, packed open days then closed above fashion. Two required skin closure. flap preferred due simplicity improved coverage defect inferiorly. Nineteen healed primarily. A superficial was drained 1 patient. Midline incisional hernias developed 3 muscular patients. Omentum now harvested through left subcostal incision. Hospital stay under 2 weeks 13 One death multisystem failure prior completion our experience, grafting with therapy postcardiotomy sternotomy infections. may require packing grafting. No significant complications occurred, mortality low. incision harvesting utilized avoid delayed hernias. ( Arch Surg . 1989;124:1192-1194)