Early, aggressive debridement followed by closure with muscle flaps is thought to improve the resolution of deep sternal wound infection that occurs after sternotomy. However, persistently discharging sternal osteomyelitis remains difficult to resolve. We successfully treated 2 patients who developed deep sternal wound infection after cardiac surgery by combining one-stage debridement with implantation of gentamicin beads to fill up the evacuated bone marrow space. This approach provides a simple and effective solution for sternal osteomyelitis.
Get full access to this article
View all access options for this article.
References
1.
The Parisian Mediastinitis Study Group. Risk factors for deep sternal wound infection after sternotomy: A prospective, multicenter study. J Thorac Cardiovasc Surg1996;111:1200–7.
2.
NoyezLvan DrutenJAMulderJSchroenAMSkotnickiSHBrouwerRM. Sternal wound complications after primary isolated myocardial revascularization: The importance of the post-operative variables. Eur J Cardiothorac Surg2001;19:471–6.
3.
BaskettRJMacDougallCERossDB. Is mediastinitis a preventable complication? A 10-year review. Ann Thorac Surg1999;67:462–5.
4.
MilanoCAKeslerKArchibaldN. Sexton DJ, Jones RH. Mediastinitis after coronary artery bypass graft surgery. Risk factors and long-term survival. Circulation1995;92:2245–51.
5.
BrandtCAlvarezJM. First-line treatment of deep sternal infection by a plastic surgical approach: Superior results compared with conventional cardiac surgical orthodoxy. Plast Reconstr Surg2002;109:2231–7.
6.
De FeoMGregorioRCorteDella AMarraCAmarelliCRenzulliA. Deep sternal wound infection: The role of early debridement surgery. Eur J Cardiothorac Surg2001;19:811–6.
