Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)

<p>Abstract</p> <p>Background</p> <p>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 mortali...

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Main Authors: Musgrave Melinda, Bonneau Daniel, Latter David, Errett Lee, Osei-Tutu Kannin, Fawzy Hosam, Mahoney James
Format: Article
Language:English
Published: BMC 2011-04-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:http://www.cardiothoracicsurgery.org/content/6/1/63
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author Musgrave Melinda
Bonneau Daniel
Latter David
Errett Lee
Osei-Tutu Kannin
Fawzy Hosam
Mahoney James
author_facet Musgrave Melinda
Bonneau Daniel
Latter David
Errett Lee
Osei-Tutu Kannin
Fawzy Hosam
Mahoney James
author_sort Musgrave Melinda
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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<sup>®</sup>, 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).</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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.</p>
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spelling doaj.art-6934a3de501b4ffd815a14ff4b9d477c2022-12-21T20:55:34ZengBMCJournal of Cardiothoracic Surgery1749-80902011-04-01616310.1186/1749-8090-6-63Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)Musgrave MelindaBonneau DanielLatter DavidErrett LeeOsei-Tutu KanninFawzy HosamMahoney James<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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<sup>®</sup>, 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).</p> <p>Results</p> <p>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.</p> <p>Conclusion</p> <p>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.</p>http://www.cardiothoracicsurgery.org/content/6/1/63Sternal PlatingSternal Dehiscence
spellingShingle Musgrave Melinda
Bonneau Daniel
Latter David
Errett Lee
Osei-Tutu Kannin
Fawzy Hosam
Mahoney James
Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
Journal of Cardiothoracic Surgery
Sternal Plating
Sternal Dehiscence
title Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
title_full Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
title_fullStr Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
title_full_unstemmed Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
title_short Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)
title_sort sternal plate fixation for sternal wound reconstruction initial experience retrospective study
topic Sternal Plating
Sternal Dehiscence
url http://www.cardiothoracicsurgery.org/content/6/1/63
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