» Articles » PMID: 28163297

Deep Sternal Wound Infection After Open-Heart Surgery: A 13-Year Single Institution Analysis

Overview
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: The present study aimed to compare the clinical outcome for patients with or without muscle flap reconstruction after deep sternal wound infection due to open-heart surgery.

Methods: The study was a retrospective cohort study, including patients who developed deep sternal wound infection after open-heart surgery in the Western Denmark Region from 1999 to 2011. Journals of included patients were reviewed for clinical data regarding the treatment of their sternal defect. Patients were divided into two groups depending on whether they received a muscle-flap-based sternal reconstruction or traditional rewiring of the sternum.

Results: A total of 130 patients developed deep sternal wound infection in the study period. In all, 12 patients died before being discharged, leaving a total of 118 patients for analysis. Of these, 50 (42%) patients received muscle flap reconstruction. Muscle flap recipients had significantly longer total hospital stays (p <0.001). However, after receiving muscle flap reconstruction, patients were discharged after a median of 14 days, with 74% not needing additional surgery.

Conclusion: It is difficult to predict which patients eventually require muscle flap reconstruction after deep sternal wound infection. Although patients receiving muscle flap reconstructions have longer hospital stays, they are quickly discharged after the reconstruction.

Citing Articles

Vancomycin wound penetration in open-heart surgery patients receiving negative pressure wound therapy for deep sternal wound infection.

Kolek M, duricova J, Brozmanova H, Sistik P, Jurica J, Kankova K Ann Med. 2024; 57(1):2444544.

PMID: 39711425 PMC: 11703014. DOI: 10.1080/07853890.2024.2444544.


Effectiveness of rigid plate fixation for sternal closure in patients with a high risk of deep sternal wound infection.

Nakamura H, Miura Y, Yoshida K, Edo N, Saito R, Orihashi K J Int Med Res. 2024; 52(10):3000605241281915.

PMID: 39387194 PMC: 11468325. DOI: 10.1177/03000605241281915.


Impact of musculoskeletal disorders in patients using orthopedic equipment on sternotomy wound healing after cardiac surgery - preliminary report.

Greberski K, Luczak M, Danielecki C, Buszkiewicz K, Kazimierczak O, Burchardt P Cardiol J. 2024; 31(6):843-849.

PMID: 39017641 PMC: 11706256. DOI: 10.5603/cj.95753.


Factors associated with deep sternal wound infection after open-heart surgery in a Danish registry.

Gundestrup L, Florczak C, Riber L Am Heart J Plus. 2024; 31:100307.

PMID: 38510559 PMC: 10945964. DOI: 10.1016/j.ahjo.2023.100307.


Our Experiences in the Treatment of Anterior Chest Wall Infections (2015 - 2021).

Banjanovic B, Haxibeqiri Karabic I, Straus S, Granov N, Kabil E, Jakirlic M Mater Sociomed. 2022; 34(2):142-148.

PMID: 36199840 PMC: 9478535. DOI: 10.5455/msm.2022.34.142-148.


References
1.
Zahiri H, Lumpkins K, Kelishadi S, Zhu Y, Medina D, Conde-Green A . Significant predictors of complications after sternal wound reconstruction: a 21-year experience. Ann Plast Surg. 2012; 69(4):439-41. DOI: 10.1097/SAP.0b013e318231d1ef. View

2.
Sjogren J, Gustafsson R, Nilsson J, Malmsjo M, Ingemansson R . Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment. Ann Thorac Surg. 2005; 79(6):2049-55. DOI: 10.1016/j.athoracsur.2004.12.048. View

3.
Fleck T, Gustafsson R, Harding K, Ingemansson R, Lirtzman M, Meites H . The management of deep sternal wound infections using vacuum assisted closure (V.A.C.) therapy. Int Wound J. 2007; 3(4):273-80. PMC: 7951489. DOI: 10.1111/j.1742-481X.2006.00273.x. View

4.
Filsoufi F, Castillo J, Rahmanian P, Broumand S, Silvay G, Carpentier A . Epidemiology of deep sternal wound infection in cardiac surgery. J Cardiothorac Vasc Anesth. 2009; 23(4):488-94. DOI: 10.1053/j.jvca.2009.02.007. View

5.
Eyileten Z, Akar A, Eryilmaz S, Sirlak M, Yazicioglu L, Durdu S . Vacuum-assisted closure and bilateral pectoralis muscle flaps for different stages of mediastinitis after cardiac surgery. Surg Today. 2009; 39(11):947-54. DOI: 10.1007/s00595-008-3982-5. View