[The infected sternotomy].
In the presence of a wound infection following a sternotomy, an active surgical treatment is currently the method of choice. Large debridement followed by an effective wound closure is advised by most authors. In our experience, most cases will respond to this treatment whateither flap is used: omentum, rectus abdominis, latissimus dorsi, pectoralis major musculocutaneous flaps. However, a few patients have had repeated attempt to close the sternal defect without success. In these cases a proper surgical treatment is a life-saving procedure. Thorough debridement and closure with bipedicled pectoralis major and rectus fascio-cutaneous flaps with drainage of the mediastinum is advised. Stabilisation of thoracic wall and filling of the dead space are not mandatory.
Montandon
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Département de chirurgie, Hôpital cantonal universitaire, Genève.
D000368:Aged; D001026:Coronary Artery Bypass; D003646:Debridement / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps / Q000379:methods*; D013530:Surgical Wound Infection / Q000601:surgery*
La sternotomie infectée.