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抗生素骨水泥固定技术联合双侧胸大肌肌皮瓣无张力管理治疗正中劈开胸骨后胸骨感染

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

机构信息

Department of Cardiovascular Surgery, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, No.299 Qingyang Road, Wuxi, Jiang Su Province, 214203, China.

Department of Chronic Wound, Wuxi Ninth People's Hospital affiliated to Soochow University, No.999 Liangqing Road, Wuxi, Jiang su Province, 214062, China.

出版信息

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.

摘要

简介

心脏手术后正中胸骨切开术后深部胸骨伤口感染(DSWI)是一种具有挑战性的并发症,会影响手术的结果。本研究旨在评估抗生素骨水泥固定技术联合双侧胸大肌肌皮瓣无张力管理在治疗 DSWI 中的临床疗效。

方法

我们回顾性分析了 2020 年 1 月至 2021 年 12 月在中国一家三级医院接受抗生素骨水泥联合双侧胸大肌肌皮瓣用于心脏手术后胸骨切开术胸壁重建的 5 例 DSWI 患者的临床和随访资料。

结果

所有患者均无围手术期死亡,无术后并发症,100%伤口愈合,平均住院时间为 24 天。随访时间为 6 至 35 个月(平均 19.6 个月)。在使用抗生素骨水泥联合双侧胸大肌肌皮瓣初始重建后,没有一例出现伤口问题。

结论

我们报告了使用抗生素骨水泥固定技术联合双侧胸大肌肌皮瓣无张力管理成功治疗 DSWI 的病例。临床和随访结果良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc38/11092104/92c7bd36e595/13019_2024_2749_Fig1_HTML.jpg

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