Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Sternal reentry in a patient with previous deep sternal wound infection managed with horizontal titanium plate fixation. | Baillot et al. Journal of Cardiothoracic Surgery 2010 5 56 http content 5 1 56 JOTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Sternal reentry in a patient with previous deep sternal wound infection managed with horizontal titanium plate fixation Richard Baillot Éric Dumont Pierre Voisine Abstract Redo open-heart surgery and sternal reentry in patients with previous deep sternal wound infection DSWI and absence of sternal integrity can be a delicate and morbid task due the lack of a dissection plane between the heart and the surrounding soft tissues. Delayed sternal reconstruction and osteosynthesis with horizontal titanium plating fixation Synthes following vacuum assisted therapy KCI has recently been proposed and adopted for the treatment of DSWI. We present such a case of a patient who was successfully reoperated for valve replacement three years after coronary artery bypass grafting complicated by DSWI and initially treated with titanium plate fixation. Introduction Deep sternal wound infection remains a feared complication of cardiac surgery still associated with significant morbidity and mortality. Furthermore there is a lack of consensus for its definitive management 1 2 . We have recently adopted the routine use of negative wound pressure therapy VAC -KCI 3-5 after initial wound debridement as a bridge to delayed chest wall reconstruction with horizontal titanium plate fixation Synthes 6 . This report will focus on the case history of a patient managed according to this approach and who eventually required a redo open heart surgery. Case report A 73-year old active patient underwent triple coronary artery bypass grafting CABG in 2005 at an outside hospital. This initially uneventful procedure was followed by a DSWI which was referred to our center and managed with aggressive debridement VAC therapy and then delayed sternal wound reconstruction with horizontal titanium plate fixation Figure 1 and .
