title: Resynthesis of sternal dehiscence with autologous bone graft and autologous platelet gel.
abstract: Postoperative management of sternal dehiscence requires the organised effort of a multidisciplinary medical team, including orthopaedic surgeons, plastic surgeons, microbiologists, critical care nurses and rehabilitation experts. Clinical care of this complication impacts heavily on health-care costs, length of hospital stay, and the time to full recovery and return to regular work activity. There are various surgical approaches to sternal resynthesis, but they are often unsuccessful. In this paper, we describe the case of a 67-year-old male complaining of chronic pain due to sternal dehiscence after coronary artery bypass grafting surgery. We first report a technique for sternal resynthesis, performed in the cardiac surgery setting, using a combination of autologous bone graft and autologous platelet-derived gel (APG), and describe its postoperative management and outcome. The four-month follow-up was uneventful and a CT scan confirmed full healing of the nonunion site with solid bridging bone.
authors.affiliation: Centre for Integrated Research (CIR), Area of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Lusini
authors.forename: A
authors.initials: A
authors.lastname: Di Martino
authors.forename: C
authors.initials: C
authors.lastname: Spadaccio
authors.forename: A
authors.initials: A
authors.lastname: Rainer
authors.forename: M
authors.initials: M
authors.lastname: Chello
authors.forename: M
authors.initials: M
authors.lastname: Fabbrocini
authors.forename: R
authors.initials: R
authors.lastname: Barbato
authors.forename: V
authors.initials: V
authors.lastname: Denaro
authors.forename: E
authors.initials: E
authors.lastname: Covino
mesh_terms: D000368:Aged; D001792:Blood Platelets; D016025:Bone Transplantation / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005599:Fractures, Ununited / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D005782:Gels; D006801:Humans; D008297:Male; D053657:Platelet-Rich Plasma; D013249:Sternum / Q000293:injuries / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000517:prevention & control / Q000628:therapy*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D005782:Gels