Redo open-heart surgery and sternal reentry in patients with previous deep sternal wound infection (DSWI) and absence of sternal integrity can be a delicate and morbid task due the lack of a dissection plane between the heart and the surrounding soft tissues. Delayed sternal reconstruction and osteosynthesis with horizontal titanium plating fixation (Synthes) following vacuum assisted therapy (...

PURPOSE Deep sternal wound complications after cardiac surgery have an incidence of 2 to 8% and carry a significant mortality. The aim of this study was to evaluate the effect of thermo-reactive Nitinol clips on the incidence of postoperative deep sternal wound complications. METHODS We retrospectively reviewed 1119 consecutive patients that underwent major cardiac surgery via median sternoto...

BACKGROUND Elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing open heart operations at Providence St. Vincent Hospital. METHODS Of 8,910 patients who underwent cardiac operations between 1987 and 1993, 1,585 (18%) were diabetic. The rate of deep sternal wound infections in diabetic patients...

[18] Schulman NH, Subramanian V. Sternal wound reconstruction: 252 consecutive cases. The Lenox Hill experience. Plast Reconstr Surg 2004;114:44–48. [19] Matros E, Aranki SF, Bayer LR, McGurk S, Neuwalder J, Orgill DP. Reduction in incidence of deep sternal wound infections: random or real? J Thorac Cardiovasc Surg 2010;139:680–685. [20] Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance defi...

Methods Between 2010 and 2011, 6 patients with type IV deep sternal wound infection underwent a sternal reconstruction with a laparoscopically harvested omental flap and transverse plate fixation. The median age of the cohort (1 female and 5 males), was 72.5 years (range: 4978 years). In 5 patients, a bilateral internal thoracic artery had been used. Considerable preoperative risk factors were ...

From 19 February 1999 through 31 October 1999, 16 (8.6%) of 185 patients who underwent median sternotomy developed infections with Pseudomonas aeruginosa. Seven patients had mediastinitis, 5 had deep sternal wound infection, 2 had superficial sternal wound infection, 1 had prosthetic valve endocarditis, and 1 had sepsis. Pulsed-field gel electrophoresis confirmed that all 13 isolates that were ...

Introduction: Deep sternal wound infection (DSWI) is one of the most complex and potentially devastating complications following median sternotomy in cardiac surgery. Despite many advances in prevention, it still remains significant and ranges between 0.5% and 6.8%. We aim to study the role of vancomycin paste applied locally over sternal edges in reducing DSWI.Materials and Methods...

In cardiac surgery, poststernotomy wounds are life threatening complications, with mortality up to 50%. We described two patients, who underwent coronary artery bypass grafting and postoperatively developed a deep sternal wound infection. Reconstruction was combined with vacuum-assisted closure treatment, laparoscopic mobilization of an omental flap and split thickens skin grafts. The omental f...