Antibiotic-loaded bone cement fixation technique combined with bilateral pectoralis major muscle flaps tension-free management for sternal infection after midline sternotomy

J Cardiothorac Surg. 2024 May 14;19(1):289. doi: 10.1186/s13019-024-02749-0.

Abstract

Introduction: Deep sternal wound infection (DSWI) after midline sternotomy of cardiac surgery is a challenging complication that affects the outcome of surgery. This study aims to assess the clinical effectiveness of the antibiotic-loaded bone cement fixation technique combined with bilateral pectoralis major muscle flaps tension-free management in the treatment of DSWI.

Methods: We retrospectively analyzed 5 patients with DSWI who underwent antibiotic-loaded bone cement combined with bilateral pectoralis major muscle flaps for chest wall reconstruction after sternotomy for cardiac surgery in a tertiary hospital in China from January 2020 to December 2021. The clinical and follow-up data were retrospectively analyzed.

Results: All patients had no perioperative mortalities, no postoperative complications, 100% wound healing, and an average hospital stay length of 24 days. The follow-up periods were from 6 to 35 months (mean 19.6 months). None of the cases showed wound problems after initial reconstruction using antibiotic-loaded bone cement combined with bilateral pectoralis major muscle flaps.

Conclusions: We report our successful treatment of DSWI, using antibiotic-loaded bone cement fixation technique combined with bilateral pectoralis major muscle flaps tension-free management. The clinical and follow-up results are favorable.

Keywords: Antibiotic-loaded bone cement; Bilateral pectoralis major muscle flaps; Deep sternal wound infection; Tension-free.

MeSH terms

  • Aged
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / therapeutic use
  • Bone Cements* / therapeutic use
  • Cardiac Surgical Procedures / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pectoralis Muscles* / surgery
  • Plastic Surgery Procedures / methods
  • Retrospective Studies
  • Sternotomy* / adverse effects
  • Sternum / surgery
  • Surgical Flaps*
  • Surgical Wound Infection* / drug therapy
  • Surgical Wound Infection* / surgery