Treatment of sternal wound infections after open-heart surgery

The aim of this study was to investigate the proper treatment of infected median sternotomy wounds.

A retrospective study was conducted to investigate the proper treatment of infected median sternotomy wounds on patients with sternal wound infections from January 2007 to July 2009. The characteristics of the sternal infections and the treatment outcomes were analysed.

Ninety-seven patients with sternal wound infections were treated. A total of 32 patients acquired the infection within one month after open-heart surgery, 10 patients got the infection one to two months after the surgery, and 1 patient died two days after debridement. There were 54 patients who acquired the infection beyond two months post-surgery, while 1 patient died on the day before the operation. One patient received four cycles of wound debridement, 18 patients received two cycles and 78 patients only received one cycle. A total of 14 patients received a vacuum-assisted closure treatment. There were 73 patients who had surgery for repair of muscle flaps, 1 patient for breast tissue flap, 63 patients for pectoralis major muscle flap, and 9 patients with rectus abdominis muscle flap. There were 12 patients who received a transverse plate fixation of the sternum with titanium plating.

A positive prognosis can be obtained by the algorithm treatment based on the onset and depth of the sternal infection.