BACKGROUND: Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. METHODS: A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. RESULTS: The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1+/-3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. CONCLUSIONS: Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study.
Body Mass Index ; Comorbidity ; Diabetes Mellitus ; Humans ; Mammary Arteries ; Mediastinitis ; Mortality ; Omentum ; Postoperative Complications ; Rectus Abdominis ; Retrospective Studies ; Risk Factors* ; Staphylococcus aureus ; Sternotomy ; Surgical Flaps ; Thoracic Surgery ; Wound Infection* ; Wounds and Injuries

Knee swelling after total knee arthroplasty (TKA) is common and can lead to loss of functional performance. The aim of this study was to reveal the factors related to knee swelling after TKA. In total, 86 patients who underwent unilateral TKA were enrolled. Changes in thigh circumference at 0, 5, and 10 cm proximal from upper pole of the patella were evaluated. In addition, age, body mass index, operation time, blood loss volume, C-reactive protein, albumin, and D-dimer levels, and changes in knee flexion were also assessed preoperatively and at 7 days postoperatively. Thigh circumference at all sites increased postoperatively. Changes in thigh circumference at the superior edge of the patella correlated with changes in knee flexion (r =－0.33, p < 0.01). No significant correlation was found between the other factors. In conclusion, this study revealed a correlation between swelling and flexion after TKA, but no correlation between other factors pre-, intra-, or postoperatively. It is thus necessary to consider other factors in the future.