Introduction: Non-healing wound in the sternal region after coronary arteries bypass graft surgery is a serious complication. For healing a chronic wound, several novel approaches have been proposed recently such as using bone marrow stem cells, platelets and fibrin glue (PFG); but a non-invasive method is highly desirable in the first approach for treatment. The current study was undertaken to evaluate the effect of the combination of PFG in one treatment.
Materials And Methods: We report on the treatment of six patients with life-threatening chronic sternum wounds, which caused septicemia with multi-drug resistant pathogens. The ulcers were extensively debrided initially and were measured and photographed at weekly intervals. The combination of PFG was applied topically on the wound after every 2 days.
Results: The wounds were completely closed in five patients and significantly reduced in size in one. There was no evidence of local or systemic complications and any abnormal tissue formation, keloid or hypertrophic scarring.
Conclusions: Our study suggests, in the first approach, PFG can be used safely in order to heal a non healing sternum wound following coronary artery bypass surgery.
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http://dx.doi.org/10.4103/0970-0358.122011 | DOI Listing |
J Orthop Trauma
December 2024
Department of Orthopaedic Surgery, Regions Hospital, St. Paul, MN.
As the operative management of acute, chest wall, skeletal injury escalates throughout the world, it has become commonplace for patients with posttraumatic conditions to present with clinical reconstructive challenges as well. In addition, it is becoming clear that rib nonunions are not rare, likely more than 5% of rib fractures. No subspecialty is better equipped to address such painful conditions than orthopaedic surgery.
View Article and Find Full Text PDFInt J Surg
December 2024
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan and College of Medical, Chang Gung University, Taoyuan, Taiwan.
Background: Deep sternal wound infection (DSWI) is a severe and life-threatening complication following cardiovascular surgery. Negative pressure wound therapy (NPWT) has emerged as a promising therapeutic bridging option for DSWI. In this systematic review and meta-analysis, the authors aimed to evaluate the impact of NPWT on clinical outcomes in patients with DSWI.
View Article and Find Full Text PDFEur J Trauma Emerg Surg
January 2025
Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Background: Rib and sternum fractures are common injuries associated with cardiopulmonary resuscitation (CPR). The fracture mechanism is either direct by application of force on sternum and anterior ribs or indirect by bending through compression of the thorax. The aim of this study was to determine morphologies of rib fractures after CPR and to reevaluate prior findings on fracture localisation, type and degree of dislocation.
View Article and Find Full Text PDFJ Wound Care
January 2025
Division of Plastic Surgery, Integrated Burn & Wound Care Center, Department of Surgery, Shuang-Ho Hospital, New Taipei City, Taiwan.
Objective: Deep sternal wound infection (DSWI) is a rare but devastating complication that is estimated to occur in 1-2% of patients after median sternotomy. Current standard of care (SoC) comprises antibiotics, debridement and negative pressure wound therapy (NPWT). Hyperbaric oxygen therapy (HBOT) appears to be an effective adjuvant therapy for osteomyelitis.
View Article and Find Full Text PDFJBJS Case Connect
October 2024
North American Spine and Pain; Hainesport, New Jersey.
Case: We report a case of a 29-year-old woman who sustained a left lateral sternoclavicular joint (SCJ) dislocation. Imaging demonstrated a 30-mm gap between the sternum and medial clavicle. Given well-preserved shoulder range of motion and well-controlled pain, she was ultimately treated nonoperatively.
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