Sternal Wound Infection
Frequently Asked Questions (FAQs)
Sternal wound dehiscence is a chest wall tissue infection seen after cardiac surgeries. The sternum bone in the centre of your chest is cut in the centre to access the heart. This bone and surrounding tissue may get infected due to the interplay of many perioperative risk factors.
This complication is relatively uncommon, with incidence commonly reported to be between 0.4% and 4%.
It can cause significant morbidity and mortality ranging between 5% to 20%.
Research has identified factors relating to the increased risk of sternal dehiscence. Patient risk factors include:
Yes. Early diagnosis and timely medical therapy can help in cure.
Whenever the infection involves the bone, surgical debridement will be required.
Radical sternal debridement entails extensive removal of the infected sternum, cartilages, ribs and surrounding soft tissue. This may be followed by weeks of a specialised vacuum dressing This aids the formation of healthy healing tissue in the wound gap. This creates ground for the final plastic surgical closure of the wound.
Plastic surgeons have wound management skills, in-depth knowledge of human anatomy and experience in extensive wound healing. More often, they will be performing the debridement, vacuum dressings and wound closure surgery. The wound closure may need a ‘flap’ surgery wherein an adjoining piece of healthy tissue is rotated into the wound to bring in blood supply and aid in healing.
Recurrence is rare, if extensive debridement is done in an optimised patient. Even, if there is a recurrence, generally, it is a limited infection that responds well to medicines and dressings
This procedure requires a team approach wherein the plastic surgeon will take lead and coordinate with the microbiologists, infectious disease specialist, radiologist and cardiac surgeon. Ancilliary care will also be provided by physiotherapists and occupational therapists. The complete cure treatment may take 3-6 months and can vary between individuals.