Sternal reconstruction and omentoplasty after mediastinitis

Area of Science:

• Cardiovascular Surgery
• Infectious Disease Management
• Reconstructive Surgery

Background:

• Deep sternal infections are a significant complication following open heart surgery.
• Uncontrolled diabetes increases the risk of post-sternotomy complications.
• Previous sternal refixation attempts can complicate management.

Observation:

• A 59-year-old female presented with sternal dehiscence and infection post-aortocoronary bypass surgery.
• The patient developed severe dyspnea and paradoxical thoracic movement due to a large sternal defect.
• Computed tomography confirmed a substantial defect of the sternum.

Findings:

• Sternal defect reconstruction was performed using metal osteosynthesis with a titanium plate.
• Omentoplasty was utilized to aid in wound healing and defect closure.
• The patient experienced an excellent postoperative outcome after one year of follow-up.

Implications:

• This case demonstrates the efficacy of sternal reconstruction with titanium plates and omentoplasty for complex post-sternotomy defects.
• Effective management strategies are crucial for patients with deep sternal infections and large sternal defects.
• Successful surgical intervention can lead to excellent long-term results even in complicated cases.