title: [Classification and management of sternal wound complications after cardiac surgery].
abstract: OBJECTIVE
  To define the classification of sternal wound complications after cardiac surgery and to explore the appropriate surgical treatment.
  
  
  METHODS
  Between July 2008 and January 2014, 260 patients with sternal wound complications after cardiac surgery were treated. There were 124 males and 136 females, aged 11-75 years (mean, 49.5 years). The disease duration was 13-365 days (mean, 26.6 days) with a wound length of 1-25 cm (mean, 13.4 cm). The wounds were divided into type I (n = 70), type II (n = 64), type III (n = 42), type IV (n = 78), and type V (n = 6) according to self-generated classification for sternal wound complications after cardiac surgery. After debridement, wounds of type I and type II were repaired with local flap transplantation; wounds of type III were repaired with local flap transplantation combined with butterfly sternal fixation (n = 28), with bilateral pectoralis muscle flap combined with butterfly sternal fixation (n = 11), and with bilateral pectoralis muscle flap (n = 3); wounds of type IV were repaired with bilateral pectoralis muscle flap (n = 65), rectus abdominis muscle flap (n = 5), and pedicled omental flap (n = 8); and wounds of type V were repaired with pedicled omental flap.
  
  
  RESULTS
  All the operations were successfully performed. Three patients died after pedicled omental flap repair, including 1 case of type IV and 2 cases of type V. The hospitalization time were 4-86 days (mean, 18.3 days). Primary wound healing was obtained in 248 cases (96.5%); poor healing occurred in 9 patients, which were cured after second surgery in 8 cases and after the third surgery in 1 case.
  
  
  CONCLUSIONS
  The surgical treatment based on self-generated classification is appropriate to sternal wound complications after cardiac surgery. It can provide clinical evidence for the choice of subsequent operation.
authors.forename: Shaoyi
authors.initials: S
authors.lastname: Zheng
authors.forename: Huade
authors.initials: H
authors.lastname: Chen
authors.forename: Chuanwei
authors.initials: C
authors.lastname: Sun
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Huang
authors.forename: Huining
authors.initials: H
authors.lastname: Bian
authors.forename: Zu'an
authors.initials: Z
authors.lastname: Liu
authors.forename: Lianghua
authors.initials: L
authors.lastname: Ma
authors.forename: Hanhua
authors.initials: H
authors.lastname: Li
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Deng
authors.forename: Huanli
authors.initials: H
authors.lastname: Wang
authors.forename: Wen
authors.initials: W
authors.lastname: Lai
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D010369:Pectoralis Muscles / Q000637:transplantation*; D011183:Postoperative Complications; D056346:Sternotomy; D013249:Sternum / Q000293:injuries / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery* / Q000628:therapy; D013997:Time Factors; D014945:Wound Healing