Management of sternal osteomyelitis and mediastinal infection following median sternotomy |
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Authors: | Gao Ju Wang You-li Lu Shu-qiang Cai Ai-bing Yang Zhi-fu Han Zhi-yi Li Jiu-jiang Wen Yu-ming Geng Feng-yong Wang Wen-zhang |
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Affiliation: | Third Department of Surgery, Hospital of Aviation Industry Corporation of China, Beijing, China. gaoju188@sohu.com |
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Abstract: | Background Median sternotomy is considered the most usually performed procedure in cardiac operations. This study aimed to assess clinical effectiveness of bilateral pectoralis major muscle flaps (BPMMF) for management of sternal osteomyelitis and mediastinal infection following median sternotomy.Methods Clinical data were collected and retrospectively analyzed from twelve patients who underwent the BPMMF transposition for management of sternal osteomyelitis and mediastinal infection following median sternotomy from January 2006 to June 2009. Procedure consisted of rigorous debridement of necrotic tissues, dead space obliteration using the BPMMF, and placement of drainage tubes connected to a negative pressures generator for adequate drainage.Results No patients died of drainage, and all 12 patients had viable BPMMF when discharged from hospital. At 1 week post discharge, 2 patients presented with sternal infection but recovered following local debridement and medication. No patients showed infection recurrence during the follow-up period over 10 months.Conclusions Sternal osteomyelitis and mediastinal infection following median sternotomy may be effectively managed through rigorous debridement of infected soft tissues, resection of the damaged stermal segment, transposition of the BPMMF to fill the damaged sternum resulting from debridement, and adequate postoperative drainage. |
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Keywords: | median sternotomy sternal osteomyelitis mediastinal infection muscle flaps management |
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