Antibiotic-loaded bone cement combined with vacuum sealing drainage to treat deep sternal wound infection following cardiac surgery: the first case report

Abstract

Background Deep sternal wound infection (DSWI) is a rare but serious complication after median sternotomy, and treatment success depends mainly on surgical experience. Here we first present a case of a patient successfully treated for antibiotic-loaded bone cement (ALBC) combined with vacuum sealing drainage (VSD) of DSWI. Case presentation This case report presented a patient who underwent open heart surgery, and suffered postoperatively from a DSWI associated with enterococcus cloacae. Focus debridement combined with ALBC filling and VSD was conducted in stage I. Appropriate antibiotics were started according to sensitivity to be continued for 2 weeks until the inflammatory markers decreased to normal. One month after the surgery, patient’s wound was almost healed and was discharged from hospital with a drainage tube. Two months after the stage I surgery procedure, the major step was removing the previous ALBC, and extensive debridement in stage II. The patient fully recovered without further surgical treatment. Conclusions The results of this case suggest that ALBC combined with VSD may be a viable and safe option for deep sternal wound reconstruction.

Efficacy of in situ regenerative therapy in refractory orthopedic wounds in children

“…In addition, the biological semi-permeable membrane isolates the wound from the external environment and reduces infection. However, the use of VSD has disadvantage of pulling the wound and causing pain in the child due to the negative pressure of suction [14].…”

Evaluating the efficacy of combined flap coverage, antibiotic‐loaded bone cement and negative pressure irrigation in traumatic osteomyelitis management

“…Given that the dosage-response relationship varies among different antibiotics, it is essential to customize the mixing ratios of sensitive antibiotics with bone cement rather than adhering to a one-size-fits-all ratio. 2 Second, the pre-treatment soft tissue defect areas were 11.5 ± 1.5 (cm 2 ) and 11.4 ± 1.4 (cm 2 ) in the control and observation groups, respectively. To address such extensive soft tissue defects, it was important for readers to know whether the authors utilized a pedicled or a free flap.…”

Review on risk factors, classification, and treatment of sternal wound infection

“…It was first reported by Klemm that bone cement cannot only conduct good mechanical support but also have a certain antibacterial effect. It has been widely used in the treatment of open fractures, osteomyelitis, and prosthesis / foreign body infection [73][74][75].…”