Vacuum-assisted closure and bilateral pectoralis muscle flaps for different stages of mediastinitis after cardiac surgery

Abstract

Early BPMMF is an effective surgical treatment for DSWI in patients with an unstable sternum and osteomyelitis. VAC may be considered for patients without osteomyelitis but a stable sternum, or as adjuvant therapy in patients with comorbidity.

Vacuum-Assisted Closure Combined with a Myocutaneous Flap in the Management of Osteomyelitis in a Dog

“…Results showed that VAC reduced the risk of deep infection by almost 80% when compared to conventional dressing [19]. In agreement with this study, studies and case reports of osteomyelitis treated with negative pressure increased granulation tissue formation, decreased number of reconstructive procedures and have variably affected bacterial burden [5,11,20]. With this in mind, the VAC system was chosen to treat the patient in this report.…”

“…Donor muscle selection is based on the dimensions of the defect and function or purpose of the reconstructive procedure and can be harvested alone or as a composite flap (skin and muscle) [2][3][4]. Muscle flaps augment vascular supply of compromised wounds by inducing angiogenesis, which is used for the management of chronic osteomyelitis, shearing wounds to the distal extremities, decubital ulcers, and ablative oncological procedures [3][4][5]. The increased blood supply through transferred muscle enhances the host defense mechanism to a compromised wound by increasing local concentrations of immunoglobulins, complement, neutrophils, and oxygen tension [2,6].…”

Deep Sternal Wound Infection after Open-Heart Surgery: A 13-Year Single Institution Analysis

“…[2][3][4][5][6] The DSWI causes necrosis and breakdown of the sternum, rendering the vital organs in the thoracic cavity vulnerable; therefore, it is of utmost importance to achieve fast healing of the defect. During the past decade, there has been a trend toward using topical negative pressure (TNP) therapy to aid the healing process before rewiring the defect.…”

Successful closure of an open-window thoracostomy wound by negative-pressure wound therapy: report of a case

“…It is applied on chronic to acute wounds, such as pressure ulcers, diabetic ulcers, problematic surgical wounds, traumatic wounds, and skin grafts [1]. Negativepressure wound therapy is widely applied in the field of thoracic surgery for poststernotomy mediastinitis [2][3][4][5][6], while its use for closure of open-window thoracostomy wounds has recently been attracting attention [7][8][9][10][11][12][13].…”