A 77-year-old woman underwent surgical aortic valve replacement via hemisternotomy. Her post-operative course was unremarkable. Owing to travel and contact restrictions during the COVID pandemic, she was unable to attend routine follow up. She continued review with her local medical officer in regional New South Wales. Post 6 months following her index surgery, she was referred to the Infectious Disease Clinic of her local hospital with a non-healing lesion at the base of her hemi-sternotomy wound. Computed tomography revealed a deep sternal wound infection which extended deep to bone. She was admitted to hospital for treatment. The primary pathogen identified was Lomentospora prolificans-a dangerous fungus that affects immunosuppressed patients. Strong antifungal and adjunctive antibiotics did not contribute much to clearance of infection. Radical surgical debridement was required to obtain clean tissue margins.
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http://dx.doi.org/10.1093/jscr/rjad123 | DOI Listing |
Int Wound J
January 2025
Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China.
Int Wound J
January 2025
S. Zhu, J. Gao, W.
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 PDFJ Clin Med
January 2025
Department of Cardiac Surgery, HonorHealth, 10210 N 92nd St, Scottsdale, AZ 85258, USA.
Steel wires are often inadequate for sternal closure for patients at high risk of sternal complications. This study compares a novel sternal closure system to conventional steel wires to assess its potential to reduce sternal complication rates and improve clinical outcomes. A retrospective study was conducted on 300 consecutive patients undergoing cardiac surgery via median sternotomy.
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