Sterilization using Antibiotic-impregnated Porous Hydroxyapatite Block for Osteomyelitis of Rib and Sternum : A Case Report

Abstract

A 79-year-old woman was referred to our department with osteomyelitis of the first rib and sternum. She had previously undergone left radical mastectomy for breast cancer and partial resection of the left clavicle. Pus had been observed on the medial side of the residual clavicle. After debridement, an antibiotic-loaded porous hydroxyapatite block was placed to sterilize the wound. Although the wound was dehiscent, no positive results were obtained for bacterial culture. Because the patient's ipsilateral pectoralis major muscle had been removed during radical mastectomy, the wound was closed using sternocleidomastoid muscle and skin flaps. No evidence of wound dehiscence was apparent after 5 years. Antibiotic impregnated block placement may prove useful when local sterilization is required.