Sternal reconstruction after post-sternotomy mediastinitis.
1Leeds General Infirmary, Great George Street, Leeds, LS1 3EX, UK. pankajkaul784@btinternet.com.
Journal of Cardiothoracic Surgery
|November 4, 2017
Summary
Deep sternal wound complications after cardiac surgery are now less severe due to improved asepsis and understanding of risk factors. Advanced therapies like negative pressure wound therapy and flap reconstruction significantly improve patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease
- Wound Management
Background:
- Deep sternal wound complications (DSWC), including sternal dehiscence, infection, and mediastinitis, are infrequent but serious sequelae of cardiac surgery.
- These conditions are often viewed as manifestations of a single underlying pathological process.
Purpose of the Study:
- To provide a comprehensive review of DSWC following cardiac surgery.
- To discuss the definition, incidence, risk factors, prevention, diagnosis, microbiology, and management strategies for DSWC.
Main Methods:
- Literature review focusing on DSWC after cardiac surgery.
- Emphasis on negative pressure wound therapy (NPWT) and reconstructive plastic surgery techniques (muscle and omental flaps).
Main Results:
- DSWC are no longer associated with high morbidity and mortality rates.
- Improved aseptic techniques and a better understanding of predisposing factors have reduced DSWC incidence.
Conclusions:
- Advances in DSWC management, including NPWT and flap reconstruction, have transformed patient outcomes.
- Early recognition and appropriate surgical intervention are key to successful DSWC treatment.
Keywords:
Allogeneic bone graftsDeep sternal wound infectionsFree flapsLatissimus dorsi flapsMediastinitisNegative pressure wound therapyOmental graftsPectoralis major flapsRectus abdominis flapsSternal dehiscenceMore Related Videos
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