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Transomental Titanium Plates for Sternal Osteomyelitis in Cardiac Surgery
Author(s) -
Sansone Fabrizio,
Mossetti Claudio,
Bruna Maria Cristina,
Oliaro Alberto,
Zingarelli Edoardo,
Flocco Roberto,
del Ponte Stefano,
Casabona Riccardo
Publication year - 2011
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/j.1540-8191.2011.01336.x
Subject(s) - medicine , surgery , wound dehiscence , osteomyelitis , sternum , dehiscence , rib cage , fibrous joint , fixation (population genetics) , population , environmental health , anatomy
Introduction: Wound infection is a devastating complication resulting in a high mortality rate from 7% to 80%. The risk of recurrences depends on the depth and the extension of the infection. We present our experience of omentoplasty using transomental sternal plates.Material and Methods: Five patients (two females, mean age 61.2 ± 8.3 years) had severe osteomyelitis requiring radical sternectomy and omental flap transposition. In three cases (60%), the sternal manubrium was completely removed: in case of upper sternectomy, chest wall stability was achieved without metallic bars; in two cases chest wall stability required the use of three metallic plates for each patient (STRATOS SYSTEM) fixed on the second, third, and fourth ribs. The plates were passed through the omental flap to obtain a partial cover of the devices.Results: No patient had abdominal complications. One patient had postoperative dehiscence of the superficial wound that was treated by VAC therapy for 30 days. The length of hospital stay was 65.2 ± 45.2 days. All patients had complete wound healing and are alive after 24.0 ± 21.4 months.Conclusions: Omental flap transposition represents a good option in the treatment of sternal osteomyelitis. Partial or total sternal manubrium preservation and fixation are essential for the restoration of sternal stability. The use of transomental titanium plates provides chest wall stabilization when extensive sternal resection is required . (J Card Surg 2011;26:600‐603)