Sternotomy infections: sternal salvage and the importance of sternal stability.
OBJECTIVE
To review the management of sternal wound infection after cardiovascular surgery.


METHODS
Retrospective case study.


METHODS
All management took place in a single tertiary-care university hospital.


METHODS
Twenty-one consecutive patients seen over a 3-year period who had infected median sternotomy incisions after cardiovascular surgery.


METHODS
Surgical eradication of infection, including sternal débridement and rewiring or placement of vascularized muscle flaps, or both.


METHODS
Resolution of infection and restoration of sternal stability.


RESULTS
The development of sternal wound infection was found to be associated with sternal instability. In 12 of 17 patients treated initially with sternal débridement and rewiring the infection was cured. Vascularized muscle flap transfers were required to eradicate the infection in the remaining patients.


CONCLUSIONS
Sternal débridement and rewiring is an effective initial treatment for sternal wound infections in selected patients. Some patients may require placement of muscle flaps for definitive treatment.
Bray
P W
PW
Division of Plastic Surgery, St. Michael's Hospital, University of Toronto, Ont.
Mahoney
J L
JL
Anastakis
D
D
Yao
J K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001864:Bone Wires; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003646:Debridement / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy / Q000379:methods*; D013249:Sternum; D013524:Surgical Flaps / Q000379:methods; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome