A comprehensive surgical approach to the treatment of deep sternal wound infection after heart transplantation

Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general popul...

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Bibliographic Details
Published in:	Vestnik transplantologii i iskusstvennykh organov Vol. 23; no. 2; pp. 67 - 75
Main Authors:	V. M. Zakharevich, V. A. Mitish, T. A. Khalilulin, A. R. Zakiryanov, D. S. Ivanov, A. M. Goltz, A. A. Sukhatchev, K. S. Kiryakov, O. A. Pozdnyakov, N. Y. Zacharevich
Format:	Journal Article
Language:	English Russian
Published:	Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 12-07-2021
Subjects:	anterior chest wall wound plasty heart transplantation immunosuppressive therapy mediastinitis reosteosynthesis sternum wound infection
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Summary:	Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general population ranges from 0.5 to 4% [2, 3]. Despite developed approaches in the treatment of cardiac surgery patients, the treatment of deep sternal wound infection and surrounding tissues following a heart transplantation still remains a rather serious and pressing challenge. This paper presents a clinical observation of a heart transplant recipient, complicated by deep postoperative wound infection. The strategy of staged surgical treatment of sternal osteomyelitis consisted of surgical wound debridement, local wound debridement with vacuum dressings, and reconstructive surgery at the final stage (sternal reosteosynthesis, plasty of the anterior chest wall wound with displaced skin and fascial flaps).
ISSN:	1995-1191
DOI:	10.15825/1995-1191-2021-2-67-75