Antibiotic-loaded bone cement combined with vacuum sealing drainage to treat deep sternal wound infection following cardiac surgery: the first case report

J Cardiothorac Surg. 2021 Oct 10;16(1):292. doi: 10.1186/s13019-021-01673-x.

Abstract

Background: Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Here we first present a case of a patient successfully treated for antibiotic-loaded bone cement (ALBC) combined with vacuum sealing drainage (VSD) of DSWI.

Case presentation: This case report presented a patient who underwent open heart surgery, and suffered postoperatively from a DSWI associated with enterococcus cloacae. Focus debridement combined with ALBC filling and VSD was conducted in stage I. Appropriate antibiotics were started according to sensitivity to be continued for 2 weeks until the inflammatory markers decreased to normal. One month after the surgery, patient's wound was almost healed and was discharged from hospital with a drainage tube. Two months after the stage I surgery procedure, the major step was removing the previous ALBC, and extensive debridement in stage II. The patient fully recovered without further surgical treatment.

Conclusions: The results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.

Keywords: Antibiotic-loaded bone cement; Deep sternal wound infection; Vacuum sealing drainage.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bone Cements
  • Cardiac Surgical Procedures* / adverse effects
  • Debridement
  • Drainage
  • Humans
  • Negative-Pressure Wound Therapy*
  • Surgical Flaps
  • Surgical Wound Infection / therapy
  • Treatment Outcome
  • Wound Healing

Substances

  • Anti-Bacterial Agents
  • Bone Cements