The orthopedic approach in infected median sternotomy

A retrospective review of 10 infected median sternotomies revealed that the management may be difficult and several procedures may be required to obtain a satisfactory result. Repeated curettage was successful in four patients. The cavity created by d ebridement was treated by the temporary insertion of gentamicin beads in one patient and by the Papineau bone grafting procedure in two. In two patients the thoracic cage became unstable as a result of extensive d ebridement and was stabilized successfully by inserting Harrington compression rods. One patient died of mediastinitis.