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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 256-262, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Single-stage management of sternal wound infections

V Jeevanandam, CR Smith, EA Rose, JR Malm and NE Hugo
Department of Surgery, Columbia University College of Physicians and Surgeons, Presbyterian Hospital, New York, NY 10032.

Deep median sternotomy wound infection is a significant source of morbidity after cardiac operations. Accepted approaches in treating this complication include debridement with either sternal closure over an irrigation system or open dressings and closure by secondary intention. Muscle flaps are often used in subsequent procedures for wound closure. A single-stage procedure was developed to eliminate irrigation, open wound management, or reoperation for muscle flap closure. This approach consists of debridement and immediate closure with a pectoral musculocutaneous flap. The following report describes 31 patients treated by such a method. Compared with results of previous techniques in treating sternal wound infections, hospital study is decreased, fewer reoperations are needed, and patient management is simplified.

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