Exposed bone cement technique and pectoralis major advancement muscle flap in treatment of chronic sternal osteomyelitis after coronary artery bypass surgery
10.3760/cma.j.cn441206-20210125-00032
- VernacularTitle:开放性骨水泥技术结合胸大肌推进肌瓣治疗冠脉搭桥术后慢性胸骨骨髓炎
- Author:
Peng XU
1
;
Mingyu XUE
;
Jin WANG
;
Xiaofeng GUO
;
Fanyu BU
Author Information
1. 苏州大学附属无锡市第九人民医院，江苏 无锡 214062
- Keywords:
Coronary artery bypass surgery;
Sternal osteomyelitis;
Exposed bone cement technology;
Antibiotic bone cement
- From:
Chinese Journal of Microsurgery
2022;45(2):133-138
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyse the effect of the exposed bone cement technique combined with pectoralis major muscle flap in the treatment of chronic sternal osteomyelitis after coronary artery bypass surgery(CABS), and to summarise the clinical experience of staged surgery and comprehensive treatment.Methods:A retrospective analysis were carried out on 5 patients who had chronic sternal osteomyelitis and treated with exposed bone cement after the CABS from October 2017 to October 2020. Five patients(4 males and 1 female) met the inclusion criteria with a mean age of 65(range from 54 to 72) years old. Duration of all the chronic sternal osteomyelitis was 3 weeks to 3 months at admission. During the perioperative period, the general condition of the patients was controlled and systemic nutritional support was given. At the first stage, all patients underwent complete debridement. Then all the wounds were treated with exposed bone cement and covered by vacuum sealing drainage(VSD) to control the infection. At the second stage, bone cement was removed, and the dead cavity was packed with pectoralis major advancement muscle flap. Close attention was paid to the tension of wound, the patency of drainage catheter and the drainage after surgery. The wound healing, scar hyperplasia and complications were observed during the follow-up.Results:The suture tension was moderate, the drainage catheter was unobstructed, and a little liquid was drawn without turbid. All patients were clinically cured and entered follow-up for 6 to 15 months. During the follow-up, there was neigher recurrence of osteomyelitis nor sinus tract formation. No significant complication occurred at the last follow-up. The quality of life of the patients was significantly improved and all the patients were satisfactory to the treatment.Conclusion:Exposed bone cement technique combined with pectoralis major muscle flap is an effective method in the treatment of chronic sternal osteomyelitis after CABS. It has a good short-term treatment efficacy and is worthy for further clinical trials.
