Sternal plate fixation for sternal wound reconstruction: initial experience (retrospective study)
Hosam Fawzy1, Kannin Osei-Tutu, Lee Errett
1Division of Cardiovascular and Thoracic Surgery, Department of Surgery, Terrence Donnelly Heart Center, Keenan Research Center in the Li Ka Shing Knowledge Institute of St, Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada. hosamfawzy@hotmail.com
Journal of Cardiothoracic Surgery
|May 3, 2011
Summary
Sternal plating effectively treats sternal dehiscence after cardiac surgery, with most patients healing well. This method shows promise for managing post-sternotomy wound complications.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Wound Management
Background:
- Median sternotomy complications like infection and nonunion occur in 0.4-5.1% of cardiac procedures.
- These complications can lead to significant patient morbidity and mortality.
Purpose of the Study:
- To evaluate the initial experience with a transverse plate fixation system for sternal wound complications post-cardiac surgery.
- To assess the efficacy of sternal plating in managing sternal dehiscence with or without infection.
Main Methods:
- Retrospective chart review of 40 patients requiring sternal wound reconstruction.
- Sternal fixation using a Titanium Sternal Fixation System (three rib plates and one manubrial plate).
- Surgical debridement of soft tissue and sternal bone to healthy bleeding bone.
Main Results:
- 38 out of 40 patients healed their wounds after sternal plating.
- Two immunocompromised patients developed recurrent wound infections requiring VAC therapy.
- Median post-operative ICU stay was 1 day, with a median hospital stay of 18 days.
Conclusions:
- Sternal plating is an effective treatment for sternal wound dehiscence and instability following cardiac surgery.
- Further larger studies are needed to fully establish indications, benefits, and potential complications.
