Titanium plate fixation for a dehisced sternum following coronary artery bypass grafting: a case report
Wan Kee Kim1, Joon Bum Kim, Sung-Ho Jung
1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea.
Insights
Sternal dehiscence after cardiac surgery is a severe complication. This case study shows successful treatment of sternal osteomyelitis using resection, titanium plates, and muscle flaps.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Infectious Disease
Background:
- Sternal dehiscence is a frequent and severe complication after cardiac surgery.
- Existing treatments for sternal dehiscence often have high failure rates and poor outcomes.
- Sternal osteomyelitis presents a significant challenge in post-cardiac surgery care.
Observation:
- A patient developed sternal osteomyelitis following coronary artery bypass grafting.
- The patient had previously undergone standard treatments for sternal dehiscence without success.
- The infection led to significant sternal instability and pain.
Findings:
- Successful treatment was achieved through a multi-modal approach.
- This included wide sternal resection to remove infected bone and tissue.
- Titanium plate fixation provided stable sternal reconstruction, and pectoralis muscle flap interposition aided wound healing.
Implications:
- This case demonstrates a viable and effective treatment strategy for complex sternal osteomyelitis.
- The combined approach of resection, titanium fixation, and muscle flap offers a promising solution for treatment failures.
- This method may improve outcomes and reduce mortality associated with sternal dehiscence complications.
Abstract:
Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Treatment failure and consequent lethal results are very common, even with all the efforts to resolve sternal dehiscence such as removal of infectious tissue, muscle flap interposition, and sternal rewiring. We report on a case of sternal osteomyelitis following coronary artery bypass grafting that was successfully treated with wide sternal resection, titanium plate fixation, and pectoralis muscle flap interposition.
