Flail chest and mediastinitis with total sternal loss post pediatric heart surgery. Reconstruction technique and case report

Authors

DOI:

https://doi.org/10.47487/apcyccv.v4i4.326

Keywords:

Flail Chest, Mediastinitis, Thoracoplasty

Abstract

We present the case of a two-year-old girl, with a history of pulmonary banding surgery who underwent a chest wall stabilization technique with titanium rods and muscle flaps coverage, due to post-surgical mediastinitis associated with total sternal loss after ventricular septal defect closure surgery, debanding, and pulmonary artery plasty. The patient had a favorable postsurgical evolution.

Downloads

Download data is not yet available.

References

Costello JM, Graham DA, Morrow DF, Morrow J, Potter-Bynoe G, Sandora TJ, et al. Risk factors for surgical site infection after cardiac

surgery in children. Ann Thorac Surg. 2010;89(6):1833-41; discussion 1841-2. doi: 10.1016/j.athoracsur.2009.08.081

Yusuf E, Chan M, Renz N, Trampuz A. Current perspectives on diagnosis and management of sternal wound infections. Infect Drug Resist. 2018;16;11:961-968. doi: 10.2147/IDR.S130172

Durandy Y. Mediastinitis in pediatric cardiac surgery: Prevention, diagnosis and treatment. World J Cardiol. 2010;2(11):391-8. doi:

4330/wjc.v2.i11.391.

Aykut K, Albayrak G, Kavala A, Guzeloglu M, Karaarslan K, Hazan E. Early Repair of Sternal Instability Prevents Mediastinitis. World

J Cardiovasc Surg. 2014;4(2):13-16. doi: 10.4236/wjcs.2014.42003.

Retamal J, Becker P, González R, Ferrés M, Cerda J, Riquelme MI, et al. Infección del sitio quirúrgico en niños sometidos a cirugía

cardíaca con cierre esternal diferido: Estudio de casos y controles. Rev Chilena Infectol. 2016;33(5):495-500. doi: 10.4067/S0716-

Sanna S, Brandolini J, Pardolesi A, Argnani D, Mengozzi M, Dell’Amore A, Solli P. Materials and techniques in chest wall reconstruction: a review. J Vis Surg. 2017;26;3:95. doi: 10.21037/jovs.2017.06.10.

Sung K, Jun TG, Park PW, Park KH, Lee YT, Yang JH. Management of deep sternal infection in infants and children with advanced

pectoralis major muscle flaps. Ann Thorac Surg. 2004;77(4):1371-5. doi: 10.1016/j.athoracsur.2003.06.020.

Anderson CJ, Spruiell MD, Wylie EF, McGowan CM, Deleyiannis FW, Donaldson NJ, Heare TC. A technique for pediatric chest

wall reconstruction using custom-designed titanium implants: description of technique and report of two cases. J Child Orthop. 2016;10(1):49-55. doi: 10.1007/s11832-015-0709-1.

Kamel M, Port J, Altorki NK. Sternal resections: New materials for reconstruction. Curr Surg Rep. 2015;3(16). doi: 10.1007/s40137-

-0094-1.

Levy AS, Ascherman JA. Sternal Wound Reconstruction Made Simple. Plast Reconstr Surg Glob Open. 2019;27;7(11):e2488. doi: 10.1097/GOX.0000000000002488.

Remolina-Medina CE, Arévalo-Zamora C. Resección quirúrgica de esternón con reconstrucción con barras de titanio y malla biológica prótesis. Reporte de casos. Neumol Cir Torax. 2017;76(1):30-35.

Anslot C, Hulin S, Durandy Y. Postoperative mediastinitis in children: improvement of simple primary closed drainage. Ann Thorac Surg. 2007;84(2):423-8. doi: 10.1016/j.athoracsur.2007.03.064.

Published

2023-12-15

Issue

Section

Case reports