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Il Giornale di Chirurgia

Deep sternal wound infections: a severe complication after cardiac surgery

Clinical practice, 33 - 36
doi: 10.11138/gchir/2017.38.1.033
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Abstract
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Sternal Wound Infections (SWI) represent a dangerous complication after cardiac surgery entailing significantly longer hospital stays and worse short-term survival, especially in case of deep infections (DSWI) with the onset of osteomielitis or mediastinitis. The real incidence of SWI can be estimated between 0.25% and 10%; among the risk factors for sternal dehiscences after a longitudinal median sternotomy, several experiences underline the role of diabetes as an independent risk factor for post-operative infections, especially in patients affected by COPD with higher BMI. The application of a negative-pressure therapy, through instill modality too, assures a wound cleansing through periodic irrigation of topical solutions with particulate secretion removal; moreover it improves the granulation process owing to the increased blood flow and makes the size wound reduction easier, representing very often the treatment of first-line in DSWI and an optimal bridge for another reconstructive procedure of the sternal defect.
The following case report shows how a plastic surgical approach associated to the adoption of a VAC-therapy instill after specific antibiotictherapy has integrated and optimized the trend of a very complex clinical circumstance.

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