Sternal dehiscence, a reconstructive challenge. Case report

Int J Surg Case Rep. 2023 Oct:111:108926. doi: 10.1016/j.ijscr.2023.108926. Epub 2023 Oct 5.

Abstract

Introduction and importance: Sternotomy is the main surgical procedure used to access the heart and great vessels. Among its most important complications is post-sternotomy dehiscence with an incidence of 10 %; the main risk factors for its occurrence are diabetes mellitus, obesity or chronic obstructive pulmonary disease.

Case presentation: We present a clinical case of a 74-year-old male patient with sternal dehiscence secondary to sternotomy for myocardial revascularisation.

Clinical discussion and conclusions: Surgical dehiscence of sternotomy presents remarkable complexity and poses a significant challenge to the medical team. The therapeutic approach focuses on addressing the infection, removing the necrotic tissue and then covering the area with highly vascularised tissue. Surgical alternatives include the possibility of using a unilateral pectoralis muscle flap, an option that provides adequate sternal stability and leads to satisfactory functional and cosmetic results.

Keywords: Myocardial revascularisation; Sternum; Surgical flap; Surgical wound dehiscence.

Publication types

  • Case Reports