Sternal plate fixation for sternal wound reconstruction: initial experience (retrospective study)
Autor: | Daniel Bonneau, Kannin Osei-Tutu, James L. Mahoney, Hosam Fawzy, Melinda A. Musgrave, Lee Errett, David A. Latter |
---|---|
Rok vydání: | 2011 |
Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty medicine.medical_treatment Nonunion lcsh:Surgery lcsh:RD78.3-87.3 Surgical Wound Dehiscence Bone plate Medicine Humans Surgical Wound Infection Cardiac Surgical Procedures Sternal Plating Sternal Dehiscence Aged Retrospective Studies Ontario business.industry Wound dehiscence Soft tissue lcsh:RD1-811 General Medicine Length of Stay medicine.disease musculoskeletal system Sternotomy Cardiac surgery Surgery body regions Survival Rate surgical procedures operative Debridement lcsh:Anesthesiology Median sternotomy Cardiothoracic surgery Female Morbidity business Cardiology and Cardiovascular Medicine Bone Plates Follow-Up Studies Research Article |
Zdroj: | Journal of Cardiothoracic Surgery Journal of Cardiothoracic Surgery, Vol 6, Iss 1, p 63 (2011) |
ISSN: | 1749-8090 |
Popis: | Background Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4 - 5.1% of cardiac procedures. Although relatively infrequent, these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. Methods A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate (Titanium Sternal Fixation System®, Synthes). Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean ± SD, Median (range) or number (%). Statistical analyses were made by using Excel 2003 for Windows (Microsoft, Redmond, WA, USA). Results There were 40 consecutive patients, 31 males and 9 females. Twenty two patients (55%) were diagnosed with sternal dehiscence alone and 18 patients (45%) with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. Conclusion Sternal plating appears to be an effective option for the treatment of sternal wound dehiscence associated with sternal instability. Long-term follow-up and further larger studies are needed to address the indications, benefits and complications of sternal plating. |
Databáze: | OpenAIRE |
Externí odkaz: |