INTRODUCTION
Sternal osteomyelitis and dehisense are a common problem with an incidence rate of 0.5% to 5.0% after major cardiac surgery. [1] Recently, it has been reported that the mortality rate in deep sternum wound infection after major cardiac surgery is decreasing, but still high as 16% to 22%. [2]
Conventional treatment of sternal osteomyelitis and dehiscence includes partial or total sternal resection with intravenous antibiotic therapy, continuous irrigation with antimicrobial agents containing saline, and localized negative pressure therapy known as vacuum assisted closure. When severe inflammation cannot be controlled using these methods, debridement of the devitalized sternum is required. [3] However, the conventional treatments have some limitations, especially in severe cases. First, massive resection, which is essential to prevent recurrence, reveals a small disease-free border and does not provide enough space to hold the sternum in conventional treatment. [4] Second, when the defect is large, the remaining bony structure after resection of dead tissue is not sufficient to prevent paradoxical chest wall motion using conventional treatment.
Recently, the use of hard metal plate fixation to close the sternum was recommended and reported promising results in many centers. [5] Sternal wound dehiscence may be managed conservatively with regular wound dressings, application of negative pressure to the wound, debridement and reclosing of the sternum or a local muscle flap is recommended to close the defect. [6]