Sternal wound reconstruction following deep sternal wound infection: past, present and future: a literature review
Khashkhusha, Arwa Butt, Sundas Abdelghaffar, Mariam Wang, William Rajananthanan, Asveny Roy, Sakshi Khurshid, Bakht Noor Zeinah, Mohamed Harky, Amer
Khashkhusha, Arwa
Butt, Sundas
Abdelghaffar, Mariam
Wang, William
Rajananthanan, Asveny
Roy, Sakshi
Khurshid, Bakht Noor
Zeinah, Mohamed
Harky, Amer
Abstract
This literature review critically examines the historical, current, and prospective dimensions of sternal wound reconstruction in the specific context of deep sternal wound infection (DSWI), aiming to enhance patient outcomes and optimise surgical techniques. Preventive measures, including prophylactic antibiotic administration and surgical site preparation, are crucial in reducing the incidence of DSWI. Effective management necessitates a multidisciplinary approach encompassing surgical debridement, drainage, and sternum repair utilising diverse procedures in conjunction with antibiotic therapy. Traditional approaches to managing DSWI involved closed irrigation and drainage techniques. While these methods exhibited certain advantages, they also exhibited limitations and varying degrees of success. The current care paradigms emphasise prophylactic antibiotic administration and surgical interventions like closed suction and irrigation, vacuum-assisted closure, and flap reconstruction. Future advancements in surgical techniques and technology hold promise for further enhancing sternal wound reconstruction. This review separates and emphasises the distinct roles of prophylaxis, antibiotic treatment, and reconstructive techniques, each relevant specifically to DSWI management. Collaborative efforts between cardiac and plastic surgeons, supported by ongoing research and innovation, are indispensable to advance sternal wound restoration and achieve superior outcomes in terms of patient welfare, morbidity and mortality reduction, and surgical efficacy.
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Date
2024
Type
Article
Subject
Wound Infection, Antibiotic Prophylaxis, Sternum, Surgery, Plastic, Reconstructive Surgical Procedures
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Citation
Khashkhusha A, Butt S, Abdelghaffar M, Wang W, Rajananthanan A, Roy S, Khurshid BN, Zeinah M, Harky A. Sternal Wound Reconstruction Following Deep Sternal Wound Infection: Past, Present and Future: A Literature Review. J Cardiovasc Dev Dis. 2024 Nov 7;11(11):361. doi: 10.3390/jcdd11110361.