Surgical treatment for deep sternal wound infection after cardiac surgery

Background Deep sterna wound infection（DSWI） after median sternotomy for cardiac surgery is one of the most complex and potentially life-threatening complications. Its very difficult to treat DSWI, and there is lack of agreement regarding the best therapy strategy. Thus, we aimed to summarize our experiences of surgical treatment for DSWI, in which satisfactory clinical results were obtained. Methods We retrospectively analyzed 17 cases who suffered from DSWI after cardiac surgery in our department from January 2010 to June 2015. There were 8 male and 9 female patients with their average age of 62.7 ± 9.5 years（range 42 ~ 75 years）. All patients received reservation of part of sternum combined with vacuum-assisted suction drainage and bilateral pectoralis major myocutaneous advancement flaps. Results The average interval between cardiac surgery and diagnosed DSWI was 10.9 ± 6.5 days（range 5 ~ 21 days）. Time of vacuum-assisted suction drainage was 11.6 ± 4.8 days（range 5 ~ 15 days） and wound healing time was 27.3 ± 7.2 days（range 23 ~ 35 days）. All patients had an uneventful postoperative recovery and good wound healing. Follow-up time was 33.7 ± 13.3 months（range 8 74 months）. No recurrent infection was observed. Conclusions Reservation of part of sternum combined with vacuum-assisted suction drainage and bilateral pectoralis major myocutaneous advancement flaps is a simple and effective surgical strategy for the treatment of DSWI after cardiac surgery.