CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds.
BACKGROUND
We examined the use of CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds. Deep wound infection after median sternotomy is infrequent (1% to 5% of all cases) but is associated with significant morbidity, mortality, and cost.


METHODS
Twenty-four consecutive patients with median sternotomy wound infection were treated by one plastic surgeon using a CO2 laser to sterilize wounds after debridement and before flap closure. The rectus abdominis muscle flap was primarily used, but the choice of muscle flap was case dependent.


RESULTS
To date, no patient in this series has had postoperative wound infection, breakdown, or flap loss. One patient did have superficial skin loss.


CONCLUSIONS
Although the morbidity rate was 17%, all patients had intact wounds. None of the 5 deaths was related to wound infection. We found that CO2 laser sterilization in the surgical treatment of sternal wound infections decreased morbidity, mortality, and cost.
Lee
J S
JS
Department of Surgery, University of Oklahoma School of Medicine-Tulsa, USA.
Tarpley
S K
SK
Miller
A S
AS
D000328:Adult; D000368:Aged; D002245:Carbon Dioxide; D003363:Cost Control; D003646:Debridement; D005260:Female; D006801:Humans; D007834:Lasers; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D013242:Sterilization / Q000379:methods*; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000517:prevention & control / Q000628:therapy*
D002245:Carbon Dioxide