Post on 09-Dec-2018
STERNAL WOUND INFECTIONS
Incidence: 1-5% (Loop et al, Ann Thorac Surg
1990)
Mortality: 10-20% (De Feo et al, Ann Thorac Surg
2011)
Increase of costs 3 folds (Loop et al)
TREATMENT OPTIONS
Ancient:
-Mandelbaum and Schumaker 1963: Suction
drainage with antibiotics (Arch Surg)
-Jurkiewicz 1980: Pectoralis muscle flap closure (Ann
Surg)
Today:
-Surgical debridement
-Open wound treatment with secondary closure
-Plastic reconstructive surgery with muscle flap
RIGID STERNAL FIXATION
Reconstructive process
Sternal stability (patient comfort, accelerated
healing, decrease incident of paradoxical chest-wall
breathing)
Earlier union from accelerated osseous healing
CASE
A Thai female, 72 years old.
DM poor blood sugar control.
HT
ESRD on HD 3 times/wk
Tracheal granuloma, presenting with stridor
TVD with LM stenosis
interhos\Chest Infection.mpg