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Sternal wound reconstruction with transverse plate fixation
Orlando J Cicilioni1, Frank H Stieg, George Papanicolaou
1Florida Hospital and Orlando Regional Healthcare, USA.
Plastic and Reconstructive Surgery
|April 6, 2005
Summary
Titanium plate fixation with pectoralis flaps safely and effectively treats complicated sternal wounds, leading to faster healing and reliable bony union. This technique offers advantages over standard reconstruction for sternal dehiscence and nonunion.
Area of Science:
- Thoracic surgery
- Wound healing
- Biomaterials
Background:
- Sternal wound complications after median sternotomy, though infrequent, carry significant morbidity and cost.
- Effective treatment strategies for sternal wound infections and nonunions remain crucial.
Purpose of the Study:
- To evaluate the efficacy of titanium plate fixation combined with pectoralis advancement flaps for complicated sternal wound repair.
- To assess outcomes in patients with sternal dehiscence, osteomyelitis, and nonunion.
Main Methods:
- Retrospective review of 50 patients undergoing sternal wound repair between 1998 and 2002.
- Utilization of 2.4-mm Synthes locking reconstruction plates for transverse sternal fixation.
- Conjunction with simple bilateral pectoralis advancement flaps for complex sternal defects.
Main Results:
- Complete healing was achieved in all treated patients.
- Bony union was successful in all but one patient.
- A single late recurrence of infection around the plate occurred 3.5 years post-procedure; no deaths were reported.
Conclusions:
- Transverse titanium plate fixation and pectoralis flaps provide a safe and effective method for treating complicated sternal wounds.
- This approach facilitates earlier extubation, tension-free repair, and faster healing compared to standard muscle flap techniques.
- The technique is considered safe, easy to perform, and potentially a future standard for sternal reconstruction.