Omental transfer for the treatment of sternal infection after cardiac surgery: report of three cases.
Sternal infection is an uncommon but serious complication following cardiac surgery. We report herein three cases of postoperative sternal osteomyelitis successfully treated by omental transfer. Two patients had undergone valve surgery and the other underwent division of an accessory pathway for Wolff-Parkinson-White syndrome. Gram-positive organisms were identified in cultures of the exudate in all three patients, as Staphylococcus epidermidis in two and Methicillin-resistant Staphylococcus aureus in one, and concomitant mediastinitis was demonstrated by computed tomography in two cases. Each patient initially underwent sternal debridement and closed irrigation with 0.5% povidone-iodine solution, following which the cultured exudate from two of the patients was negative. The omentum was transferred in two of the patients because they had poor granulation tissue and in the third patient to fill a large dead space, and the postoperative course was uneventful in all three patients. Thus, we conclude that omental transfer is a useful technique for the treatment of postoperative sternal osteomyelitis.
Omura
K
K
First Department of Surgery, Kanazawa University School of Medicine, Japan.
Misaki
T
T
Takahashi
H
H
Kobayashi
K
K
Watanabe
Y
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003646:Debridement; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery; D009852:Omentum / Q000637:transplantation*; D010019:Osteomyelitis / Q000000981:diagnostic imaging / Q000209:etiology; D011859:Radiography; D013203:Staphylococcal Infections / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D013212:Staphylococcus epidermidis; D013249:Sternum / Q000000981:diagnostic imaging; D013530:Surgical Wound Infection / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*