Extensive suprasternal dehiscence reconstruction with NPWT and advancement flaps following cardiac surgery.

J Surg Case Rep

Plastic Surgery Department, Hungarian Defense Forces Medical Centre, Robert K. sgt. 44, 1134 Budapest, Hungary.

Published: November 2023

Treatment of suprasternal wound infection (SSWI) following cardiac surgery is not a clearly developed procedure. We report our female patient's secondary SSWI treatment following bypass surgery. An obese female patient with unstable angina underwent an urgent, uneventful off-pump coronary artery bypass operation. An SSWI appeared within a week. After negative pressure wound therapy (NPWT), the sternum was rewired. In the previously irradiated territory of the left breast necrosis formed, a plastic surgeon reconstructed a defect. This procedure failed NPWT was restarted again, and a secondary reconstructive plastic surgery intervention was necessary. Despite extensive tissue mobilization, the central part of the reconstructive area necrotized, and we had to cover it with a split thickness skin mash graft. The irradiation therapy increases the incidence of suprasternal and/or sternal infection. It was possible to manage large soft tissue defects with bilateral and rotational advancement flaps.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642447PMC
http://dx.doi.org/10.1093/jscr/rjad623DOI Listing

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