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Báo cáo y học: "Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study)"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Sternal plate fixation for sternal wound reconstruction: initial experience (Retrospective study). | Fawzy et al. Journal of Cardiothoracic Surgery 2011 6 63 http www.cardiothoracicsurgery.Org content 6 1 63 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Sternal plate fixation for sternal wound reconstruction initial experience Retrospective study 1 2 1 1 1 2 Hosam Fawzy Kannin Osei-Tutu Lee Errett David Latter Daniel Bonneau Melinda Musgrave and James Mahoney2 Abstract Background Median sternotomy infection and bony nonunion are two commonly described complications which occur in 0.4 - 5.1 of cardiac procedures. Although relatively infrequent these complications can lead to significant morbidity and mortality. The aim of this retrospective study is to evaluate the initial experience of a transverse plate fixation system following wound complications associated with sternal dehiscence with or without infection following cardiac surgery. Methods A retrospective chart review of 40 consecutive patients who required sternal wound reconstruction post sternotomy was performed. Soft tissue debridement with removal of all compromised tissue was performed. Sternal debridement was carried using ronguers to healthy bleeding bone. All patients underwent sternal fixation using three rib plates combined with a single manubrial plate Titanium Sternal Fixation System Synthes . Incisions were closed in a layered fashion with the pectoral muscles being advanced to the midline. Data were expressed as mean SD Median range or number . Statistical analyses were made by using Excel 2003 for Windows Microsoft Redmond WA USA . Results There were 40 consecutive patients 31 males and 9 females. Twenty two patients 55 were diagnosed with sternal dehiscence alone and 18 patients 45 with associated wound discharge. Thirty eight patients went on to heal their wounds. Two patients developed recurrent wound infection and required VAC therapy. Both were immunocompromised. Median post-op ICU stay was one day with the median hospital stay of 18 days after plating. Conclusion .