학술논문

A comprehensive surgical approach to the treatment of deep sternal wound infection after heart transplantation
Document Type
article
Source
Vestnik Transplantologii i Iskusstvennyh Organov, Vol 23, Iss 2, Pp 67-75 (2021)
Subject
heart transplantation
wound infection
sternum
mediastinitis
immunosuppressive therapy
anterior chest wall wound plasty
reosteosynthesis
Surgery
RD1-811
Language
Russian
ISSN
1995-1191
Abstract
Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general population ranges from 0.5 to 4% [2, 3]. Despite developed approaches in the treatment of cardiac surgery patients, the treatment of deep sternal wound infection and surrounding tissues following a heart transplantation still remains a rather serious and pressing challenge. This paper presents a clinical observation of a heart transplant recipient, complicated by deep postoperative wound infection. The strategy of staged surgical treatment of sternal osteomyelitis consisted of surgical wound debridement, local wound debridement with vacuum dressings, and reconstructive surgery at the final stage (sternal reosteosynthesis, plasty of the anterior chest wall wound with displaced skin and fascial flaps).