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Infected sternotomy wounds
D T Gault1, C Huddleston, B M Jones
1Department of Plastic Surgery, Hospital for Sick Children, London, UK.
Insights
Rectus abdominis myocutaneous island flaps effectively treated median sternotomy wound infections in three infants. This early surgical intervention resolved infections, shortened hospital stays, and protected the mediastinum.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Infectious Disease Management
Background:
- Median sternotomy is a common surgical approach in infants.
- Wound infections following median sternotomy can lead to serious complications.
- Prompt management is crucial for favorable outcomes.
Observation:
- Three infants developed median sternotomy wound infections.
- One infant presented with a retrosternal abscess requiring drainage.
- Two infants experienced wound dehiscence.
Findings:
- All three infants underwent repair using a rectus abdominis myocutaneous island flap.
- Primary wound healing was achieved in all cases post-flap reconstruction.
- The flap successfully covered and protected the exposed mediastinum.
Implications:
- Early rectus abdominis myocutaneous island flap reconstruction is an effective treatment for median sternotomy wound infections in infants.
- This approach can resolve infection, reduce hospitalization duration, and prevent mediastinal complications.
- Surgical intervention with myocutaneous flaps offers a reliable solution for complex pediatric wound management.
Abstract:
Three babies who developed infection in their median sternotomy wounds are reported. In one child, a retrosternal abscess was drained and in the other two cases, the wounds dehisced. The wound cavities were filled with a rectus abdominis myocutaneous island flap and in each case, the wounds healed primarily. Early flap repair resolved the infection, shortened the hospital stay and provided protection to the exposed mediastinum.