Thorac Cardiovasc Surg 2007; 55(6): 402-405
DOI: 10.1055/s-2007-965402
Case Reports

© Georg Thieme Verlag KG Stuttgart · New York

Large Thoracic Wall Hematoma following Sternal Reconstruction with Transversal Plate Fixation after Deep Sternal Wound Infection

C. Schimmer1 , P. Keith1 , K. Neukam1 , M. Beissert2 , R. Leyh1
  • 1Department of Heart Surgery, University Würzburg, Würzburg, Germany
  • 2Department of Radiology, University Würzburg, Würzburg, Germany
Further Information

Publication History

Received November 23, 2006

Publication Date:
24 August 2007 (online)

Introduction

The management of deep sternal wound infection (DSWI) associated with sternal dehiscence and/or mediastinitis constitutes in every case a challenging and controversial problem for a cardiothoracic surgeon. Over the years, quite an impressing array of various methods, materials and surgical techniques have been proposed to address this dreaded complication of cardiac surgery which occurs with an incidence of 1 - 8 % [[1], [2], [3], [4], [5], [6], [7], [8]]. Recently, transverse plate fixation of the sternum combined with simple bilateral pectoralis advancement has been described as a safe and effective method to achieve sternal refixation in cases of DSWI [[1]].

References

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  • 2 Sjögren J, Malmsjö M, Gustafsson R, Ingemansson R. Poststernotomy mediastinitis: a review of conventional surgical treatments, vacuum-assisted closure therapy and presentation of the Lund University Hospital mediastinitis algorithm.  Eur J Cardiothorac Surg. 2006;  30 898-905
  • 3 Molina J E, Nelson E C, Smith R RA. Treatment of postoperative sternal dehiscence with mediastinitis: twenty-four year use of a single method.  J Thorac Cardiovasc Surg. 2006;  132 782-787
  • 4 Sjögren J, Gustafsson R, Nilsson J, Malmsjö M, Ingemansson R. Clinical outcome after poststernotomy mediastinitis: vacuum-assisted closure versus conventional treatment.  Ann Thorac Surg. 2005;  79 2049-2055
  • 5 Wong C HK, Senewiratne S, Garlick B, Mullany D. Two-stage management of sternal wound infection using bilateral pectoralis major advancement flap.  Eur J Cardiothorac Surg. 2006;  30 148-152
  • 6 Pai S, Gunja N J, Dupak E L, McMahon N L, Roth T P, Lalikos J F, Dunn R M, Francalancia N, Pins G D, Billiar K L. In vitro comparison of wire and plate fixation for midline sternotomies.  Ann Thorac Surg. 2005;  80 962-968
  • 7 Raman J, Song D H, Bolotin G, Jeevanandam V. Sternal closure with titanium plate fixation - a paradigm shift in preventing mediastinitis.  Int Cardiovasc Thorac Surg. 2006;  5 336-339
  • 8 Song D H, Lohmann R F, Renucci J D, Jeevanandam V, Raman J. Primary sternal plating in high-risk patients prevents mediastinitis.  Eur J Cardiothorac Surg. 2004;  26 367-372

Dr. Christoph Schimmer

Department of Heart Surgery
University Würzburg

Oberdürrbacherstraße 6

97080 Würzburg

Germany

Fax: + 49 9 31 20 13 30 09

Email: Schimmer_c@klinik.uni-wuerzburg.de

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