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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(05): 470-474
DOI: 10.5999/aps.2018.00829
Case Report

Successful management of absent sternum in an infant using porcine acellular dermal matrix

Roy Alfred Semlacher 
Department of Plastic and Reconstructive Surgery, Mary Bridge Children’s Hospital & Health Network, MultiCare Health System, Tacoma, WA, USA
,
Muhammand A.K. Nuri
Seattle Children’s and Mary Bridge Children’s Regional Cardiac Surgery Program, Tacoma, WA, USA
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Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood Creactive protein levels declined to ≤2 mg/L, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

Keywords

Sternum - Acellular dermis - Surgical mesh - Thoracic surgery - Negative pressure wound therapy

The authors thank Tyler Seick (Mary Bridge Children’s Hospital, Tacoma, WA, USA) for assist of surgery.




Publication History

Received: 10 July 2018

Accepted: 15 December 2018

Article published online:
03 April 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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