Background Although the utility of flaps for the treatment of sternal wound infections following
median sternotomy has been reported for 30 years, there have been few reports on the
risk factors for complications after reconstruction. The objective of this investigation
was to identify factors related to complications after the reconstruction of sternal
wound infections.
Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal
wound infection over a 5-year period was performed. Clinical data including age, sex,
body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery,
wound depth, mortality rate, type of reconstructive procedure, and complication rate
were collected.
Results The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5%
of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected
the rate of wound closure complications (P=0.041). A significant difference in the
number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery
and postoperative complications (P=0.048). The complication rates of the pectoralis
major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major
flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%,
and 35.7%, respectively.
Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors
for complications after reconstruction. The omentum flap volume may be related to
the complications associated with the omentum flap transfer in the present study.
Keywords
Mediastinitis - Postoperative complications - Surgical flaps - Risk factors - Omentum
