title: [Sternal osteomyelitis - Surgical treatment concepts].
abstract: Sternal osteomyelitis is a potentially fatal condition following cardiac surgery. Sternal osteomyelitis should be diagnosed as early as possible followed by an interdisciplinary radical debridement. Subsequently plastic reconstructive surgery is necessary for defect reconstruction. This can be achieved by a number of established pedicled and free flap plastic surgery procedures. The choice of flap procedures is based on defect geometry and the individual patient situation, including potential flap donor sites. Smaller defects can generally be reconstructed by pedicled flap transfer. For extensive sternal defects, free flap transplantation is now a well-established therapeutic option. In some patients lacking sufficient recipient vessels, the creation of an arteriovenous (AV) loop as recipient vessel is necessary. In summary, successful therapy of sternal osteomyelitis is based on early interdisciplinary treatment by the various surgical subspecialties.
authors.affiliation: Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstr. 12, 91054, Erlangen, Deutschland. justus.beier@uk-erlangen.de.
authors.forename: J P
authors.initials: JP
authors.lastname: Beier
authors.affiliation: Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstr. 12, 91054, Erlangen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Arkudas
authors.affiliation: Gefäßchirurgische Abteilung, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Lang
authors.affiliation: Herzchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Weyand
authors.affiliation: Plastisch- und Handchirurgische Klinik, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Krankenhausstr. 12, 91054, Erlangen, Deutschland.
authors.forename: R E
authors.initials: RE
authors.lastname: Horch
mesh_terms: D006348:Cardiac Surgical Procedures; D003646:Debridement; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D010019:Osteomyelitis / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D019651:Plastic Surgery Procedures; D056346:Sternotomy; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000601:surgery
keywords: Cardiac surgical procedures; Debridement; Median sternotomy; Microsurgical free flaps; Pedicled flaps