DEEP MEDIAN STERNAL WOUND INFECTION: MANAGEMENT AND RECONSTRUCTION

Abstract

During a 30-month period. 2S patients with deep infected median sternotomy wounds were managed surgically. Fifteen patients had chronic sternal osteomyelitis with associated costochondruis, 7 patients had only costochondritis, and 3 patients had dehiscence and/or mediastinitis. Twenty were male and 5 were female Their ages rangedfrom 11 to 71 years. Nine patients had 11 failed previous attempts by other physicians. Debridement a/bone or sternedomy with removal of infected cartilage and soft tissue following primary reconstruction was carried out A total of35 operations were done Twenty-one patients were successfully treated in one session, however, in 4 patients with recurrent infection, a total of10 additional operations were done. Inadequate debridement was the most common cause of recurrence. Recurrent infections were managed with another muscle or omental flap, in addition to debridement or resection. We conclude that muscle transposition after adequate debridement or resection is an excellent method for deep and chronic sternal wound infections.