Deep sternal wound infection after open heart surgery--reconstructive options
Alexander Andersen Juhl1, Vibeke Koudahl, Tine Engberg Damsgaard
1The Department of Plastic Surgery, Aarhus University Hospital, Aarhus, Denmark. alexander@oncology.dk
Scandinavian Cardiovascular Journal : SCJ
|March 13, 2012
Summary
Reconstructing sternal defects after deep sternal wound infection is complex. While muscle flap transposition is common, evidence for optimal surgical management and protocols for deep sternal wound infection remains limited.
Area of Science:
- Cardiothoracic Surgery
- Plastic Surgery
- Infectious Disease
Background:
- Deep sternal wound infection (DSWI) following open-heart surgery presents significant reconstructive challenges.
- Management necessitates collaboration between plastic and thoracic surgeons.
Purpose of the Study:
- To review the literature on methods for reconstructing sternal defects resulting from DSWI after open-heart surgery.
Main Methods:
- A comprehensive literature search was conducted across Cochrane, Embase, PubMed, and SveMed+ databases in December 2011.
- Inclusion criteria focused on adult patients with DSWI after open-heart surgery.
Main Results:
- 224 original papers were identified, primarily focusing on surgical techniques.
- No randomized controlled trials were found for reconstructive options, indicating generally low levels of evidence.
Conclusions:
- Despite treatment evolution for DSWI, consensus on optimal surgical management and standardized protocols is lacking.
- Muscle flap transposition is a well-documented technique.
- Topical negative pressure therapy is increasingly recommended as an adjunct to surgical reconstruction.
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