Sternal Wound Reconstruction with Porcine Acellular Dermal Matrix (strattice) for Poststernotomy Mediastinitis

Sternal reconstruction could be a complex and challenging procedure. Common indications are defects after heart surgery, infections, tumour ablation, radiation necrosis, congenital deformities and trauma. Aloplastic materials are often used for sternal stabilization and regional aps are applied to provide well vascularized soft tissue coverage. Although numerous materials are available, acellular dermal matrice have some advantage that could be of bene t in the repair of the anterior mediastinum and chest wall. We present a case of a 72-year-old male patient whit mediastinitis and sternal dehiscence after triple-vessel coronary artery bypass grafting and failure of the initial chest wall closure. After conservative treatment and VAC-therapy, titanium plates were used to restore the sternal continuity. Porcine acellular dermal matrix (StratticeTM Tissue Matrix) was applied for wrapping the xation plates and reinforcing the pectoralis muscle aps used for soft tissue coverage. Due to its ability to become incorporated and vascularized, to resist wound infections and to provide stability, Strattice seems to be a promising, although probably not enough ef cient alternative of the synthetic materials. To our knowledge, this is the rst report in the Bulgarian scienti c literature of sternal reconstruction by using a porcine acellular dermal matrix (Strattice).