BACKGROUND Anatomical variations of the sternal angle and anomalies of the sternum are unique happenings of major clinical significance.It is known that misplaced sternal angles may lead to inaccurate counting of ribs and create challenges with intercostal nerve blocks and needle thoracostomies. Sternal foramina may pose a great hazard during sternal puncture, due to inadvertent cardiac or grea...

Sternal non-union is a severe complication of sternotomy closure following open heart surgeries. Healing problems typically occur in 0.3% to 5% of patients. Technetium-99m methylene diphosphonate (99mTc-MDP) bone scintigraphy has been used to assess bone nonunion to predict the healing response for proper management.  In this report, we present the case of a marked sternal nonunio...

The use of crutches following a sternotomy raises the concern of sternal dehiscence. We discuss secure reinforced sternal closure, classify sternal distractional forces and discuss the postoperative mobilization process.

BACKGROUND Deep sternal wound infection after cardiac surgery carries high morbidity and mortality. Our strategy for deep sternal wound infection is aggressive strenal debridement followed by vacuum-assisted closure (VAC) therapy and omental-muscle flap reconstrucion. We describe this strategy and examine the outcome and long-term quality of life (QOL) it achieves. METHODS We retrospectively ...

Here I represent a rare case of deep sternal wound infection due to methicillin resistant staphylococcus aureus which occurred beyond twelve months after the Coronary artery bypass graft surgery. The nationwide incidence rate of sternal surgical site infection has decreased significantly in recent years. With the decreasing sternal surgical site infection rate, question I addressed from this ca...

CONTEXT Despite the routine use of prophylactic systemic antibiotics, sternal wound infection still occurs in 5% or more of cardiac surgical patients and is associated with significant excess morbidity, mortality, and cost. The gentamicin-collagen sponge, a surgically implantable topical antibiotic, is currently approved in 54 countries. A large, 2-center, randomized trial in Sweden reported in...

Postopereative sternal dehiscence is one of the most important complications of median sternotomy which may cause pulmonary dysfunction and mediastinitis. We are reporting a patient with sternal dehiscence after coronary artery bypass surgery that underwent application of thermoreactive nitinol clips in addition to Robicsek procedure. Using thermoreactive nitinol clips method together with Robi...