Hemangioma/surgery* ; Humans ; Precancerous Conditions ; Sternum/surgery*

Background: In recent years, open heart surgery has developed rapidly in Vietnam. Sternal infection is a very serious complication for this surgery, it lead to increasing treatment costs and higher risk of mortality. Treatment of local infections is always a difficult technique in sternal wound infections after open heart operations. Objectives: (1) To improve and apply two techniques called \u201cdemi \ufffd?open + irrigation\ufffd? and \u201cclosed \ufffd?Redon drainage\ufffd? (2) To evaluate the effects of these techniques. Subjects and method: 20 cases of sternal infection (at Viet Duc hospital and some other hospitals in Ha Noi) were researched and described prospectively about diagnosis, techniques and treatment results. The subjects were divided in to 2 group based on the infection processing techniques. Results:Diagnosis had to reply on clinical signals (100%). Bacterial culture only provided 45% positive results, Pseudomonas aeruginosa (44.4%) were obtained more than Staphylococcus au\u2019reus (22.2%). Both techniques have their own reasonable creativeness and the standardized process, improving the limitations of ordinary technique, providing high treatment effectiveness \ufffd?85% have recovered after only one operation. Conclusion: For treatment of local infections, two techniques are both very efficient and suitable with the conditions in Vietnam, especially \u201cclosed \ufffd?Redon drainage\ufffd?technique.
Thoracic Surgery/methods ; Infection/ therapy ; Sternum ;

Adult ; Female ; Humans ; Sternum ; pathology ; surgery ; Thymus Neoplasms ; pathology ; surgery

OBJECTIVETo improve sternal elevation for pectus excavatum to be more simple, less injured and less recurrent.

METHODSWe modified procedures for the sternal elevation for pectus excavatum by dispersal of the shortened fibrous bundle connection with central tendon of the diaphragm, correction of the reverse angle of sternocostales joins, transverse cuneiform anterior osteotomy of sternum and reconnection of oblique resected costal cartilage.

RESULTSSince March 1997, 8 children (4 - 10-year-old) with the pectus excavatum have been treated by this modified sternal elevation, 4 of them who suffer from quick heart pulse improved their heart rate immediately during the operation, all patients have less bleeding and good cosmetic appearance without any complications. There were satisfactory results without recurrence after 6 months to 1 year follow-up.

CONCLUSIONThe modified sternal elevation for pectus excavatum is safe, effective and reliable method.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Funnel Chest ; surgery ; Humans ; Male ; Sternum ; surgery

Aged ; Chondrosarcoma ; surgery ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Sternum ; surgery ; Titanium

OBJECTIVETo introduce the application of "tennis racket" flap with fascial pedicle on the healthy chest for radiation ulcer after surgical treatment of breast cancer.

METHODSThe " tennis racket" flap was designed on the healthy chest along the cartilage with fascia pedicle near the sternum. 9 cases were treated. The flaps size ranged from 5.0 cm x 3.5 cm to 13 cm x 11 cm with pedicle size of 2-8 cm in length and 2.0-3.0 cm in width.

RESULTSAll the 9 flaps survived completely with satisfactory appearance. The patients were followed up for 2 months to 3 years without ulcer reoccurrence.

CONCLUSIONSThe "tennis racket" flap has a slender fascial pedicle without major blood vessel. It has the advantages of good flexibility for rotation and large flap size for the reconstruction of the radiation ulcer after surgical treatment of breast cancer.

Breast Neoplasms ; radiotherapy ; Fascia ; Female ; Humans ; Radiodermatitis ; surgery ; Skin Ulcer ; etiology ; surgery ; Sternum ; Surgical Flaps ; Tennis

We at Keimyung University Dongsan Medical Center experienced simultaneous repair of pectus excavatum and secundum atrial septal defect. We used resection deformed perichondrium, raising sternum at right angle to secure good operative field for open heart surgery. Mechanical ventilation was applied which could be weaned on postoperative 2 hours. The hospital course was uneventful without any other sequale. The patient was discharged on postoperative day 6.
Funnel Chest* ; Heart Septal Defects, Atrial* ; Humans ; Respiration, Artificial ; Sternum ; Thoracic Surgery

BACKGROUND: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Treatment failure and consequent lethal outcomes are very common. The aim of this study was to evaluate titanium plate fixation as a treatment for sternal dehiscence following major cardiac surgery. MATERIALS AND METHODS: Between 2010 and 2012, 17 patients underwent sternal reconstruction using horizontal titanium plating for the treatment of post-cardiac-surgery sternal dehiscence. The plates were cut and shaped, and then were fixed to corresponding costal segments using 2-3 titanium screws per each side. RESULTS: The median age of our patients was 66 years (range, 50 to 78 years) and 9 were female. Indications for sternal reconstruction included aseptic sternal dehiscence in 3 patients and osteomyelitis in 14 patients including 6 patients who were diagnosed with mediastinitis. During the operation, sternal resection and autologous flap interposition were combined in 11 patients. One patient died due to sepsis. Two patients required additional soft tissue wound revisions. Another patient presented with a tuberculous wound infection which was resolved using anti-tuberculosis medications. The postoperative course was uncomplicated in the other 13 patients. CONCLUSION: Titanium plate fixation that combines appropriate debridement and flap interposition is very effective for the treatment of sternal dehiscence following major cardiac surgery.
Debridement ; Female ; Humans ; Mediastinitis ; Osteomyelitis ; Reoperation ; Sepsis ; Sternum ; Thoracic Surgery ; Titanium ; Treatment Failure ; Wound Infection

BACKGROUND: There are several advantages to the ministernotomy approach. The skin incision is much smaller than the traditional median sternotomy incision. This approach allows the patients to return to normal life more quickly and provide them with good self-image. MATERIAL AND METHOD: From April to July 1998, we performed a ministernotomy via lower half sternum in 25 patients. There were 10 males(40%) and 15 females(60%) with a mean age of 30+/-16 years(range 3 to 55 years). The body surface area ranged from 0.58 to 1.9 m2(mean 1.5 to 0.4 m2). A vertical skin incision of 11cm in mean length was made in the midline over the sternum extending inferiorly from the third intercostal space. The sternum was divided vertically in the midline from the xyphoid process to the level of second intercostal space using a standard saw and then transversely to the left(n=17) or to both sides(n=4) of the second intercostal space using an oscillating saw. The sternum was divided vertically only in children (n=4). RESULT: The ministernotomy was used in 25 consecutive patients undergoing mitral valve replacement(n=10), repair of ventricular septal defect(n=4) and atrial septal defect(n=11). There was no significant complication related to ministernotomy. The mean ICU stay time 20 hours. Patient and family acceptance was very high. CONCLUSION: We concluded that minimally invasive cardiac surgery via ministernotomy can be done safely. These methods may benefit the patients with lesser discomfort, smaller incision, and earlier ICU discharge than the traditional incision.
Body Surface Area ; Child ; Humans ; Mitral Valve ; Skin ; Sternotomy* ; Sternum ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery*

OBJECTIVE: The design and development of split memory alloy sternum bone plate are discussed, and the effect of split memory alloy sternum bone plate internal fixation in the treatment of sternal fractures are analysed. METHODS: The structure of the product is designed according to the anatomy and physiological characteristics of human bones, and the cross section shape of the product is designed according to the cross section shape of human bones. Internal fixation is effective in the treatment of sternal fracture. RESULTS: The split memory alloy sternal plate was successfully designed and developed, and all the patients with sternal fractures treated by internal fixation were clinically healed, the hospitalization and fracture healing time were significantly shortened, and no obvious complications occurred. CONCLUSIONS The application of split memory alloy sternal plate internal fixation in the treatment of sternal fracture has the advantages of small trauma, simple operation, safety, reliable fixation, good histocompatibility and less complications, and is conducive to promoting fracture healing and respiratory function improvement.
Alloys ; Bone Plates ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Sternum/surgery*