Sternal wound reconstruction: 252 consecutive cases. The Lenox Hill experience

The authors report on a personal experience of 252 consecutive secondary sternal wound closures resulting from a series of 11,601 median sternotomies at a single institution performed over a 14-year period. Protocols for treatment are described from the time of initial consultation with the plastic surgeon through the period of postoperative care. The patients and wounds were diverse and complex, with each factor requiring careful analysis before a treatment course was selected. Complete and thorough wound débridement with the elimination of dead space ensured by the placement of healthy tissue and the maintenance of active suction at the operative site were the common elements of success.