Department of Cardiovascular Surgery, Wuxi People's Hospital/Wuxi Affiliated Hospital of Nanjing Medical University, Wuxi, 214203, China.
Department of Chronic Wound, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, 214062, China.
J Cardiothorac Surg. 2021 Oct 10;16(1):292. doi: 10.1186/s13019-021-01673-x.
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.
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.
The results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.
深部胸骨伤口感染(DSWI)是正中开胸术后罕见但严重的并发症,治疗的成功主要取决于手术经验。在这里,我们首次报告了一例成功接受载抗生素骨水泥(ALBC)联合真空密封引流(VSD)治疗 DSWI 的患者。
本病例报告了一名接受心脏直视手术的患者,术后发生与阴沟肠杆菌相关的 DSWI。一期行清创术联合 ALBC 填充和 VSD。根据药敏结果开始使用适当的抗生素,持续使用 2 周,直到炎症标志物降至正常。术后 1 个月,患者伤口几乎愈合,带引流管出院。一期手术后 2 个月,主要步骤是取出之前的 ALBC,并进行二期广泛清创。患者完全康复,无需进一步手术治疗。
本病例结果表明,ALBC 联合 VSD 可能是深部胸骨伤口重建的一种可行且安全的选择。