whether they are female (score = 2), diabetic (score = 1), Hb 1Ac > 7.5% (score = 3), BMI ≥ 35 (score = 2), ejection fraction ≤ 45% (score = 1), and emergency surgery (score = 2). Identification of patients who are at high or medium risk for SWI then triggers a cascade of events and interventions aimed at eliminating the occurrence of SWI. One of the key areas we have aggressively focused on is...

In cardiac surgery, sternal wound infection (SWI) continues to be one of the most serious postoperative complications. Coagulase-negative staphylococci (CoNS) have become the most common causative agents of SWI. However, many CoNS species are resistant to routine intravenous antibiotic prophylaxis. 2000 cardiac surgery patients were randomised to routine prophylaxis with intravenous isoxazolyl ...

OBJECTIVE We sought to assess the efficiency of two different sternal closure techniques in preventing sternal wound instability in high-risk patients. MATERIALS AND METHODS Between January 2009 and February 2012, 2068 consecutive cardiac patients were prospectively collected in our database. The 561 patients in whom the thermoreactive nitilium clips (Flexigrip) have been used (group A) were ...

Management of deep sternal wound infection (SWI), a serious complication after cardiac surgery with high morbidity and mortality incidence, requires invasive procedures such as, debridement with primary closure or myocutaneous flap reconstruction along with use of broad spectrum antibiotics. The purpose of this clinical series is to investigate the presence of biofilm in patients with deep SWI....

Methods Between 2008 and 2012, 24 patients with a complicated sternal wound underwent a sternal reconstruction with bilateral pectoralis advancement flaps and a transverse plate fixation system. The median age of the cohort (4 female and 20 males), was 65.8 years (range: 33-83 years). In 19 patients, a bilateral internal thoracic artery had been used. Considerable preoperative risk factors were...

Introduction. Case reports have emerged with identification of Gordonia bronchialis infections including sternal wound infections and foreign bodies such as central lines and shunts. Case presentation. We present a case that demonstrates the need to consider Gordonia infection as a cause of sternal wound infection and highlights the utility of novel diagnostics to aid in the identification of u...

Background The treatment of deep wound sternal infection requires loco-regional pedicled flaps, usually with muscular flaps. Perforator propeller flaps represent the ultimate progress in history reconstructive surgery. We report here our experience superior epigastric artery perforator (SEAP) to repair defect. Patients and methods Six patients presenting wounds were treated SEAP flap, between M...