Surgical outcomes of sternal rigid plate fixation from 2005 to 2016 using the American College of Surgeons-National Surgical Quality Improvement Program database

Current Management of Sternal Wounds

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Describe the pathogenesis, classification, and risk factors of sternal wound infection. 2. Discuss options for sternal stabilization for the prevention of sternal wound infection, including wiring and plating techniques. 3. Discuss primary surgical reconstructive options for deep sternal wound infection and the use of adjunctive methods, such as negative-pressure wound therapy.

SUMMARY

Poststernotomy sternal wound infection remains a life-threatening complication of open cardiac surgery. Successful treatment relies on timely diagnosis and initiation of multidisciplinary, multimodal therapy.

Negative Pressure Wound Therapy Can Prevent Surgical Site Infections Following Sternal and Rib Fixation in Trauma Patients: Experience From a Single-Institution Cohort Study

The management of patients with traumatic injuries can be a challenge. Many require surgical intervention, are at an increased risk of surgical site infections (SSIs), and have an associated increase in hospital length of stay and cost. Closed-incision negative pressure therapy (ciNPT) has shown benefits in the management of certain surgical sites by preventing infection and improving wound healing. In the setting of chest wall reconstruction after traumatic sternal and/or rib fractures, no study so far has examined the efficacy of this treatment. We report a single-center retrospective cohort study, examining outcomes using ciNPT following rib and sternal fixation in trauma patients. Data on 71 patients who suffered from rib and/or sternal fractures, requiring surgical intervention, were collected over a time period of three years, from December 2016 to December 2019. The patient population was 66% male (47/71), had a mean age of 63.3 years (range 23-90 years old), and suffered from injuries related to motor vehicle or motorcycle accidents (45/71, 63%). Among the patients treated with ciNPT, none developed signs of SSIs during their initial hospitalization or within two months post-discharge follow-up. Negative pressure therapy is an effective wound care management system for preventing infections in closed-incision sites following chest wall reconstruction.