Management Outcome of Patients with Infected Sternotomy Wounds

Abstract

Objective: to evaluate management outcomes of post-sternotomy wounds. Study Design: Retrospective longitudinal study. Place and Duration of Study: Department of Plastic Surgery, Shifa International Hospital, Islamabad Pakistan, from Jan 2020 to Dec 2021. Methodology: We reviewed 35 patients who had developed sternal wound infections post-cardiothoracic surgery. Outcomes of the study were measured using the SF-36 Quality of Life questionnaire. Results: Our patients presented with either Pairolero Type-II 11(31.4%) or Type-III 19(54.2%) sternal wound infection. Preoperatively patients scored 296.667±69.40 in physical functional, 100.00±30.51 in limitations due to physical health, 16.67±37.90 in role limitation due to emotional problems, energy/fatigue scored 43.53±23.70, emotional well-being 163.33±23.54, social functioning as 11.40±11.66, pain score 31.25±19.90 and general health 131.67±35.31. The improvement in scores was noted in all domains postoperatively. Physical functioning mean scored as 790.00±48.07, role limitations due to physical health scored as310.34±67.32, role limitations due to emotional problems scored as 266.67±47.94, energy/fatigue 284.67±18.71, emotional well being 448.67±18.71, social functioning 185.83±12.60, pain score 164.17±22.01 and general health 316.67±34.95. Thirty-four (97.1%) out of 35 patients recovered well postoperative, with a maximum follow-up of 4 years and a minimum follow-up of 1 year. One patient expired on the sixth day of muscle flap coverage of the wound due to cardiac arrest. Conclusion: A positive prognosis can be obtained by this treatment protocol.

Keywords

• Debridement
• Infection
• Sternotomy
• Treatment
• Wounds