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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Hyperbaric oxygen therapy for primary sternal osteomyelitis: a case report.

Tales Rubens de Nadai1, Rosemary Furlan Daniel, Mariane Nunes de Nadai

  • 1Department of Surgery and Anatomy, Ribeirão Preto Faculty of Medicine, University of São Paulo, Brazil Avenida Bandeirantes, 3900, Ribeirão Preto, SP, 14048-900, Brazil. talesusp@yahoo.com.br.

Journal of Medical Case Reports
|June 29, 2013
PubMed
Summary

Primary sternum osteomyelitis, a rare infection, requires prompt surgical debridement and antibiotics. This case highlights successful treatment with debridement, antibiotics, and hyperbaric oxygen therapy for improved patient outcomes.

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Area of Science:

  • Infectious Diseases
  • Surgical Oncology
  • Hyperbaric Medicine

Background:

  • Primary osteomyelitis of the sternum is exceptionally rare, constituting only 0.3% of all reported osteomyelitis cases.
  • Diagnosis necessitates a high index of suspicion and confirmation via percutaneous biopsy.
  • Standard treatment involves periosteal and bone resection, with early surgical intervention and bacterial control being the most effective approach.

Purpose of the Study:

  • To report a case of primary sternum osteomyelitis treated with surgical debridement and antibiotics.
  • To evaluate the potential adjunctive role of hyperbaric oxygen therapy in wound healing.
  • To emphasize the importance of timely surgical intervention in managing this rare condition.

Main Methods:

  • A 39-year-old male presented with symptoms suggestive of sternum infection, initially misdiagnosed.
  • Magnetic resonance imaging revealed a large chest wall collection, leading to surgical debridement.
  • Treatment included intravenous antibiotics (metronidazole and cefotaxime), followed by oral ciprofloxacin and hyperbaric oxygen therapy.

Main Results:

  • Surgical debridement successfully removed infected tissue and pus from the sternum.
  • The patient received a combination of broad-spectrum antibiotics and hyperbaric oxygen therapy.
  • Wound closure was achieved by postoperative day 10, with the patient discharged on postoperative day 15.

Conclusions:

  • Prompt surgical debridement and antibiotic therapy are crucial for successful management of primary sternum osteomyelitis.
  • Hyperbaric oxygen therapy may potentially aid in accelerated wound healing, although further research is needed.
  • This case underscores the effectiveness of a multi-modal treatment approach for this rare and severe infection.