Our Treatment Strategy for Sternum Osteomyelitis and Mediastinitis

Abstract

Postoperative mediastinitis and sternal osteomyelitis are serious complications that are difficult to manage, and they may be fatal. In our facility, the V.A.C.ATS^TM treatment system has been actively used to manage these complications since it became insurance-covered. Although it is possible to sufficiently perform wound bed preparation through favorable management, such as granulation and infection control, would healing cannot be achieved in a large number of cases due to the necessity of calculating medical fees within limited time frames. Therefore, in deep wound infections, it is necessary to finally perform reconstructive surgery using muscle (skin) or omental flaps to fill the dead space for wound closure. This paper reports such a case managed in our facility, and reviews the therapeutic strategies.