INTRODUCTION
Sternal osteomyelitis and dehisense are a common problem with an
incidence rate of 0.5% to 5.0% after major cardiac surgery. [1]
Recently, it has been reported that the mortality rate in deep sternum
wound infection after major cardiac surgery is decreasing, but still
high as 16% to 22%. [2]
Conventional treatment of sternal osteomyelitis and dehiscence includes
partial or total sternal resection with intravenous antibiotic therapy,
continuous irrigation with antimicrobial agents containing saline, and
localized negative pressure therapy known as vacuum assisted closure.
When severe inflammation cannot be controlled using these methods,
debridement of the devitalized sternum is required. [3] However, the
conventional treatments have some limitations, especially in severe
cases. First, massive resection, which is essential to prevent
recurrence, reveals a small disease-free border and does not provide
enough space to hold the sternum in conventional treatment. [4]
Second, when the defect is large, the remaining bony structure after
resection of dead tissue is not sufficient to prevent paradoxical chest
wall motion using conventional treatment.
Recently, the use of hard metal plate fixation to close the sternum was
recommended and reported promising results in many centers. [5]
Sternal wound dehiscence may be managed conservatively with regular
wound dressings, application of negative pressure to the wound,
debridement and reclosing of the sternum or a local muscle flap is
recommended to close the defect. [6]