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Related Concept Videos

Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Tracheostomy Care I: Pre-procedural Steps

A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
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Related Experiment Video

Updated: May 19, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
15:11

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Published on: January 5, 2015

Post-sternotomy chronic osteomyelitis: is sternal resection always necessary?

Maria Pia Tocco1, Milva Ballardini, Marcello Masala

  • 1Thoracic Surgery Unit, San Filippo Neri Hospital, Rome, Italy. mptocco@yahoo.it

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|August 8, 2012
PubMed
Summary

Post-sternotomy osteomyelitis can be treated effectively with systemic antimicrobial therapy, avoiding sternal resection. Accurate diagnosis and tailored treatment duration are key for successful outcomes in chronic sternal infections.

Related Experiment Videos

Last Updated: May 19, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
15:11

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Published on: January 5, 2015

Area of Science:

  • Infectious Diseases
  • Cardiothoracic Surgery
  • Medical Microbiology

Background:

  • Post-sternotomy osteomyelitis is a serious complication following open-heart surgery.
  • Traditional treatment often involves sternal resection, which can lead to significant morbidity.
  • Alternative, less invasive strategies are needed to manage this challenging infection.

Purpose of the Study:

  • To investigate alternative treatment strategies for post-sternotomy osteomyelitis.
  • To evaluate the efficacy of non-surgical or conservative surgical approaches.
  • To report clinical experience without resorting to sternal resection.

Main Methods:

  • A 4-year retrospective study of 70 patients with post-sternotomy sternocutaneous fistulas.
  • Patients were treated with medical therapy alone (45) or conservative surgery including debridement and wire removal (25).
  • Vacuum-assisted closure (VAC) therapy was used in 7 patients; diagnosis confirmed by 3D CT scans.

Main Results:

  • Complete wound healing was achieved in 67 out of 70 patients.
  • Successful treatment was observed even in long-standing fistulas and complex infections (mycobacterial, Aspergillus).
  • Fistula relapses (6 patients) were potentially linked to insufficient antibiotic duration for resistant bacteria like CoNS and Corynebacterium.

Conclusions:

  • Systemic antimicrobial therapy, guided by microbiological and radiological studies, can effectively treat post-sternotomy chronic osteomyelitis without mandatory resection.
  • Prolonged antimicrobial therapy (6-18 months) is recommended for CoNS and Corynebacterium infections.
  • 3D CT scans are valuable for diagnosis and treatment monitoring; VAC therapy showed limited benefit for osteomyelitis itself but may aid in wound management.