Operative Technique
The patient who underwent cardiac surgery 2 months ago were applied many
treatment methods for sternal dehiscence and osteomyelitis, but no
success was achieved. The operation was started with general anesthesia.
The sternum was exposed through the previous midline incision. The old
steel wires were removed and the sternum was resected due to long-term
infection and extensive deformation of the sternum. Pectoralis muscle
flaps were partially mobilized and adducted. The large defect was closed
using a large prolene patch. Proper sized transversal titanium plates
were selected. Due to the sternum bone was severely destroyed by
infection, longer transversal titanium plates were chosen to achieve
thoracic stability. Healthy tissues were detected on the ribs. A total
of 4 titanium plates were placed intermittently. The plates were fixed
to the ribs with titanium locking screws. The pectoral muscle flaps
adducted to the plates by the plastic surgery team. A total of 3 drains
were placed, one in the mediastinum and two between the thoracic wall
and muscle structures. Deformed skin tissue due to long-term infection
was resected, and the remaining healthy tissues were closed according to
the anatomical plan.