Extensive Suprasternal Dehiscence Reconstruction with NPWT and Advancement Flaps Following Cardiac Surgery

Overview

Journal J Surg Case Rep

Publisher Oxford University Press

Specialty General Surgery

Date 2023 Nov 15

PMID 37965535

Authors

Boglarka Juhasz

Robert Tamas

Affiliations

Soon will be listed here.

Abstract

Treatment of suprasternal wound infection (SSWI) following cardiac surgery is not a clearly developed procedure. We report our female patient's secondary SSWI treatment following bypass surgery. An obese female patient with unstable angina underwent an urgent, uneventful off-pump coronary artery bypass operation. An SSWI appeared within a week. After negative pressure wound therapy (NPWT), the sternum was rewired. In the previously irradiated territory of the left breast necrosis formed, a plastic surgeon reconstructed a defect. This procedure failed NPWT was restarted again, and a secondary reconstructive plastic surgery intervention was necessary. Despite extensive tissue mobilization, the central part of the reconstructive area necrotized, and we had to cover it with a split thickness skin mash graft. The irradiation therapy increases the incidence of suprasternal and/or sternal infection. It was possible to manage large soft tissue defects with bilateral and rotational advancement flaps.

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