Case report
Treatment of Sternal Wound Infection Using a Free Myocutaneous Flap

https://doi.org/10.1016/j.athoracsur.2015.01.078Get rights and content

Deep sternal wound infections are potentially life-threatening complications after cardiac operations because they can spread into the mediastinum and cause postoperative morbidity and mortality. We present a 65-year-old man with a history of coronary artery bypass grafting. A large sternal defect was left after debridement. After brief vacuum-assisted closure (VAC), a free myocutaneous flap of the anterolateral thigh (ALT) was used to fill the dead space. At the 9-month follow-up, the wound had healed completely without tissue loss or complications, and the patient returned to normal life. This was a successful treatment of a deep sternal wound with free flap coverage.

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Comment

The mortality rate for patients with DSWI after debridement and flap coverage is about 8% to 25% 2, 3. Adequate debridement of necrotic tissues followed by reconstruction using vascularized flaps is a common technique for the management of such infections showing dehiscence 2, 5. The application of VAC for a short duration followed by definitive closure appears to be beneficial in the treatment of sternal wound infections [6], with low mortality and reinfection rates and short hospital stays [7]

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