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 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). © 2021 Russian Transplant Society. All rights reserved.

Authors
Zakharevich V.M.1, 2 , Mitish V.A. 3, 4, 5 , Khalilulin T.A.1, 2 , Zakiryanov A.R.1 , Ivanov D.S.1 , Goltz A.M.1 , Sukhatchev A.A.1 , Kiryakov K.S.1 , Pozdnyakov O.A.1 , Zacharevich N.Y.1
Publisher
ФГБУ "Национальный медицинский исследовательский центр трансплантологии и искусственных органов имени академика В.И. Шумакова" Минздрава России.
Number of issue
2
Language
Russian
Pages
67-75
Status
Published
Volume
23
Year
2021
Organizations
  • 1 Shumakov National Medical Research Center of Transplantology and Artificial Organs, Moscow, Russian Federation
  • 2 Sechenov University, Moscow, Russian Federation
  • 3 Research Institute of Emergency Pediatric Surgery and Traumatology, Moscow, Russian Federation
  • 4 Vishnevsky National Medical Research Center of Surgery, Moscow, Russian Federation
  • 5 Peoples' Friendship University of Russia, Moscow, Russian Federation
Keywords
Anterior chest wall wound plasty; Heart transplantation; Immunosuppressive therapy; Mediastinitis; Reosteosynthesis; Sternum; Wound infection
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