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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(04): 291-302
DOI: 10.5999/aps.2018.01151
Review Article

Deep sternal wound infections: Evidence for prevention, treatment, and reconstructive surgery

Luigi Schiraldi 
Department of Surgery, Hospital du Valais, Sion, Switzerland
Department of Plastic and Reconstructive Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
,
Gaby Jabbour
Department of Plastic and Reconstructive Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
Department of Surgery, Hamad General Hospital, Doha, Qatar
,
Paolo Centofanti
Department of Cardiac Surgery, Mauriziano Hospital, Turin, Italy
,
Salvatore Giordano 
Department of Plastic and General Surgery, Turku University Hospital, Turku, Finland
,
Etienne Abdelnour 
Department of Thoracic Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
,
Michel Gonzalez 
Department of Thoracic Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
,
Wassim Raffoul 
Department of Plastic and Reconstructive Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
,
Pietro Giovanni di Summa 
Department of Plastic and Reconstructive Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland
› Author AffiliationsThe authors are thankful to Mr. Marco Schmid, Arch. and Mrs. Carol De Simio for their valuable advice and help with illustrations.
› Further Information
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Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.

Keywords

Sternum - Infection - Reconstructive surgical procedure - Sternotomy


Publication History

Received: 03 September 2018

Accepted: 03 July 2019

Article published online:
28 March 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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