Operative Technique
The patient who underwent cardiac surgery 2 months ago were applied many treatment methods for sternal dehiscence and osteomyelitis, but no success was achieved. The operation was started with general anesthesia. The sternum was exposed through the previous midline incision. The old steel wires were removed and the sternum was resected due to long-term infection and extensive deformation of the sternum. Pectoralis muscle flaps were partially mobilized and adducted. The large defect was closed using a large prolene patch.  Proper sized transversal titanium plates were selected. Due to the sternum bone was severely destroyed by infection, longer transversal titanium plates were chosen to achieve thoracic stability. Healthy tissues were detected on the ribs. A total of 4 titanium plates were placed intermittently. The plates were fixed to the ribs with titanium locking screws. The pectoral muscle flaps adducted to the plates by the plastic surgery team. A total of 3 drains were placed, one in the mediastinum and two between the thoracic wall and muscle structures. Deformed skin tissue due to long-term infection was resected, and the remaining healthy tissues were closed according to the anatomical plan.