2017, Number 4
<< Back Next >>
Cir Card Mex 2017; 2 (4)
Manejo de dehiscencia esternal en posoperatorio complicado de cirugía cardiaca con sistema StraTos
Gómez-Saviñón VG, Vásquez-Jiménez X, Gómez-Sánchez M, Herrera-Alarcón V
Language: Spanish
References: 14
Page: 131-134
PDF size: 269.87 Kb.
ABSTRACT
A 66-year-old woman who had undergone mitral valve replacement, tricuspid repair and thrombectomy. She required tracheostomy and presented mediastinitis, being managed with VAC
® and closed with multitortion technique. Sternal wound presented sternal crepitation and erythema, so it was explored finding out sternal dehiscence with wires integrity, and VAC
® system was instaled, with negative cultures and macroporous sternal branches. So, it was decided to perform sternal closure with the StraTos
® system, achieving her hospital discharge. The StraTos
® system is a novel chest fixation system that may be effective for the management of sternal dehiscence. However, worldwide experience is limited.
REFERENCES
Voss B, Bauernschmidtt R, Will A, et al. Sternal reconstruction with titaniumplates in complicated sternal dehiscence. Eur J Cardiothorac Surg 2008;34:139-45.
Milton AF. Tratatado de técnica operatoria general y especial. Barcelona: EditorialLabor, 1944; 756pp
Julian OC, Lopez-Belio M, Dye WS, Javid H, Grove WJ. The median sternal incisionin intracardiac surgery with extracorporeal circulation: a general evaluationof its use in heart surgery. Surgery 1957;42:753-61.
Losanoff JE, Jones JW, Richman BW. Primary closure of median sternotomy:techniques and principles. Cardiovasc Surg 2002;10:102-10.
Ozaki W, Buchman SR, Lannettoni MD, Frankenburg EP. Biomechanical studyof sternal closure using rigid fixation techniques in human cadavers. Ann ThoracSurg 1998;65:1660-5.
A. Lemaignen, G. Birgand, W. Ghodhbane, et al. Sternal wound infection aftercardiac surgery: incidence and risk factors according to clinical presentation. ClinMicrobiol Infect 2015;21:674e11- 8.
Ottino G, De Paulis R, Pansini S, et al. Major sternal wound infection after openheartsurgery: A multivariate analysis of risk factors in 2,579 consecutive operativeprocedures. Ann Thorac Surg 1987;44:173-9.
Immer FF, Durrer M, Mühlemann KS, Erni D, Gahl B, Carrel TP. Deep sternalwound infection after cardiac surgery: modality of treatment and outcome. AnnThorac Surg 2005;80:957-61.
Meszaros K, Fuehrer U, Grogg S, et al. Risk factors for sternal wound infectionafter open heart operations vary according to type of operation. Ann Thorac Surg2016;101:1418-25.
Shumacker HB Jr, Mandelbaum I. Continuous antibiotic irrigation in the treatmentof infection. Arch Surg. 1963;86:384-7.
Ceresa F, Casablanca G, Patanè F. Complicated sternal dehiscence treated with thestrasbourg thoracic osteosyntheses system (STRATOS) and the transposition ofgreater omentum: a case report. J Cardiothorac Surg 2010;28:53.
Sansone F, Mossetti C, Bruna MC, et al . Transomental titanium plates for sternalosteomyelitis in cardiac surgery. J Card Surg 2011;26:600-3.
Hajj-Chahine J, Allain G, Tomasi Corbi P, Jayle C. Late postcardiotomy sternaldehiscence: a simple approach using Stratos® system. J Card Surg 2013; 28:632-4.
Orsini B, D’Journo XB, Reynaud-Gaubert M, Thomas PA. Sternal dehiscenceafter clamshell incision in lung transplantation treated with the STRAsbourg ThoracicOsteosyntheses System (STRATOS). Ann Thorac Surg 2014;97: e55-7.