title: Sternotomy infections: sternal salvage and the importance of sternal stability.
abstract: 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.
authors.affiliation: Division of Plastic Surgery, St. Michael's Hospital, University of Toronto, Ont.
authors.forename: P W
authors.initials: PW
authors.lastname: Bray
authors.forename: J L
authors.initials: JL
authors.lastname: Mahoney
authors.forename: D
authors.initials: D
authors.lastname: Anastakis
authors.forename: J K
authors.initials: JK
authors.lastname: Yao
mesh_terms: 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