title: Transomental titanium plates for sternal osteomyelitis in cardiac surgery.
abstract: BACKGROUND
  Wound infection is a devastating complication resulting in a high mortality rate from 7% to 80%. The risk of recurrences depends on the depth and the extension of the infection. We present our experience of omentoplasty using transomental sternal plates.
  
  
  METHODS
  Five patients (two females, mean age 61.2 ± 8.3 years) had severe osteomyelitis requiring radical sternectomy and omental flap transposition. In three cases (60%), the sternal manubrium was completely removed: in case of upper sternectomy, chest wall stability was achieved without metallic bars; in two cases chest wall stability required the use of three metallic plates for each patient (STRATOS SYSTEM) fixed on the second, third, and fourth ribs. The plates were passed through the omental flap to obtain a partial cover of the devices.
  
  
  RESULTS
  No patient had abdominal complications. One patient had postoperative dehiscence of the superficial wound that was treated by VAC therapy for 30 days. The length of hospital stay was 65.2 ± 45.2 days. All patients had complete wound healing and are alive after 24.0 ± 21.4 months.
  
  
  CONCLUSIONS
  Omental flap transposition represents a good option in the treatment of sternal osteomyelitis. Partial or total sternal manubrium preservation and fixation are essential for the restoration of sternal stability. The use of transomental titanium plates provides chest wall stabilization when extensive sternal resection is required.
authors: Division of Cardiac Surgery, Mauriziano Umberto I Hospital, Turin, Italy. fabrisans@katamail.com
authors: Fabrizio
authors: F
authors: Sansone
authors: Claudio
authors: C
authors: Mossetti
authors: Maria Cristina
authors: MC
authors: Bruna
authors: Alberto
authors: A
authors: Oliaro
authors: Edoardo
authors: E
authors: Zingarelli
authors: Roberto
authors: R
authors: Flocco
authors: Stefano
authors: S
authors: Del Ponte
authors: Riccardo
authors: R
authors: Casabona
mesh_terms: D001860:Bone Plates; D006348:Cardiac Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D010019:Osteomyelitis / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D012189:Retrospective Studies; D056346:Sternotomy / Q000379:methods; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000601:surgery*; D014025:Titanium; D016896:Treatment Outcome
chemical_list: D014025:Titanium