SURGICAL TREATMENT STRATEGIES OF DEEP STERNAL WOUND INFECTION FOLLOWING CARDIAC SURGERY

Area of Science:

• Cardiothoracic Surgery
• Infectious Disease Management
• Wound Healing Research

Background:

• Deep sternal wound infection (DSWI) presents a significant life-threatening risk post-cardiac surgery.
• Evaluating diverse surgical strategies for DSWI is critical for improving patient outcomes.

Purpose of the Study:

• To compare the efficacy of different surgical treatment approaches for deep sternal wound infection (DSWI).
• To analyze the impact of treatment timing on DSWI management outcomes.

Main Methods:

• Retrospective analysis of 70 DSWI patients across two regional hospitals.
• Comparison of early surgical debridement with negative pressure wound therapy (NPWT) and rewiring versus delayed treatment with flap reconstruction.

Main Results:

• Hospital 1 (early intervention) showed a 15% infection recurrence rate, while Hospital 2 (delayed treatment) had a 24% recurrence rate.
• Prompt treatment in Hospital 1 preserved sternal tissue, enabling rewiring, whereas Hospital 2 often required flap reconstruction due to extensive bone destruction.
• Mortality rates were comparable, but early intervention facilitated better infection control.

Conclusions:

• Timely surgical debridement is paramount in managing DSWI.
• Rewiring is a viable sternal closure method when adequate tissue is preserved.
• Pectoralis major flap reconstruction is effective for extensive bone defects in DSWI cases.