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A comprehensive surgical approach to the treatment of deep sternal wound infection after heart transplantation

https://doi.org/10.15825/1995-1191-2021-2-67-75

Abstract

Deep wound infection of the anterior chest wall tissues in patients after transsternal cardiac surgery despite intensive developments in surgical techniques and improvement of antibacterial chemotherapy, remains a genuine concern worldwide [1]. The incidence of this complication in the general population ranges from 0.5 to 4% [2, 3]. Despite developed approaches in the treatment of cardiac surgery patients, the treatment of deep sternal wound infection and surrounding tissues following a heart transplantation still remains a rather serious and pressing challenge. This paper presents a clinical observation of a heart transplant recipient, complicated by deep postoperative wound infection. The strategy of staged surgical treatment of sternal osteomyelitis consisted of surgical wound debridement, local wound debridement with vacuum dressings, and reconstructive surgery at the final stage (sternal reosteosynthesis, plasty of the anterior chest wall wound with displaced skin and fascial flaps).

About the Authors

V. M. Zakharevich
Shumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov University
Russian Federation

Moscow



V. A. Mitish
Research Institute of Emergency Pediatric Surgery and Traumatology; Vishnevsky National Medical Research Center of Surgery; Peoples’ Friendship University of Russia
Russian Federation

Moscow



T. A. Khalilulin
Shumakov National Medical Research Center of Transplantology and Artificial Organs; Sechenov University
Russian Federation

Moscow



A. R. Zakiryanov
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



D. S. Ivanov
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Denis S. Ivanov

1, Shchukinskaya str., Moscow, 123182



A. M. Goltz
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



A. A. Sukhatchev
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



K. S. Kiryakov
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



O. A. Pozdnyakov
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



N. Y. Zacharevich
Shumakov National Medical Research Center of Transplantology and Artificial Organs
Russian Federation

Moscow



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Review

For citations:


Zakharevich V.M., Mitish V.A., Khalilulin T.A., Zakiryanov A.R., Ivanov D.S., Goltz A.M., Sukhatchev A.A., Kiryakov K.S., Pozdnyakov O.A., Zacharevich N.Y. A comprehensive surgical approach to the treatment of deep sternal wound infection after heart transplantation. Russian Journal of Transplantology and Artificial Organs. 2021;23(2):67-75. https://doi.org/10.15825/1995-1191-2021-2-67-75

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ISSN 1995-1191 (Print)