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Management of chronic sternal osteomyelitis
The Annals of Thoracic Surgery
|July 1, 1985
Summary
Chronic sternal osteomyelitis after bypass surgery can be managed with total sternectomy and pectoralis flaps. This approach successfully restored function in two patients with disabling sinus tracts.
Area of Science:
- Cardiovascular Surgery
- Infectious Disease
- Thoracic Reconstruction
Background:
- Chronic sternal osteomyelitis is a severe complication following coronary artery bypass grafting (CABG).
- Draining sinus tracts can lead to significant patient disability.
Observation:
- Two patients developed chronic sternal osteomyelitis post-CABG, presenting with debilitating draining sinus tracts.
- Conservative management failed, necessitating aggressive surgical intervention.
Findings:
- Complete eradication of infection required total sternectomy and excision of infected costal cartilage.
- Reconstruction using bilateral pectoralis major myocutaneous advancement flaps was performed without anterior chest wall stabilization.
- Both patients achieved full functional recovery and returned to work with minimal pulmonary compromise.
Implications:
- Total sternectomy with pectoralis flaps is an effective treatment for chronic sternal osteomyelitis post-CABG.
- This reconstructive technique allows for significant functional recovery without chest wall stabilization.
- Highlights the importance of aggressive surgical management for refractory sternal infections.