Chest Wall Reconstruction Using Sternal Plating in Patients With Complex Sternal Dehiscence

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Surgical Innovation

Background:

• Complex sternal dehiscence presents significant reconstructive challenges.
• Effective management requires addressing infection and structural instability.
• Previous methods may have limitations in achieving complete sternal repair.

Purpose of the Study:

• To evaluate the efficacy of demineralized bone matrix in sternal reconstruction for complex sternal dehiscence.
• To assess the outcomes of a multi-step reconstructive approach including infection control and bone grafting.
• To determine the long-term stability and functional recovery following this surgical technique.

Main Methods:

• Retrospective review of 14 patients with complex sternal wounds.
• Infection eradication using vacuum-assisted closure and antibiotics.
• Sternal reconstruction with plate fixation, bone morphogenetic protein (BMP), and demineralized bone matrix.
• Pectoral myocutaneous flap coverage for the reconstructed sternum.

Main Results:

• All 14 patients achieved stable chest walls at 6 months post-procedure.
• No recurrent sternal dehiscence or wound infections were observed.
• Complete resolution of sternal pain and return to normal activity were reported by all patients.

Conclusions:

• Sternal reconstruction using demineralized bone matrix, combined with BMP and flap closure, is effective for complex sternal dehiscence.
• This reconstructive strategy leads to favorable outcomes, including chest wall stability and pain resolution.
• The approach offers a viable and encouraging solution for challenging sternal wound complications.