Treatment Of Sternal Osteomyelitis After Open Heart Surgery With Combined Negative Pressure Wound Therapy With Rectus Abdominis Myocutaneous Flap Transfer: A Case Report

The effectiveness of combination of negative pressure wound therapy with rectus abdominis myocutaneous flap transfer in treating sternal osteomyelitis associated with open heart surgery is not clear. Here we reported a case. A 57 years old male with past medical history of Diabetes underwent coronary artery bypass grafting surgery (CABG) in our hospital. After CABG, the wound was infected and dehiscenced, postoperative osteomyelitis of sternum was diagnosed. There was no significant improvement in the wound condition after conservative treatment with topical antibiotics and dressing change for one week. Thus combinatory negative pressure wound therapy with rectus abdominis myocutaneous flap transfer was performed sequentially. Briefly, after thorough debridement and removal of sequestrum, continuous negative pressure wound therapy was applied; then phase II wound repair with rectus abdominis myocutaneous flap transfer was performed to heal the wound. The combined treatment was successful. After the treatment, clean wound and growth of fresh granulation were observed, and the rectus abdominis myocutaneous flap survived and the wound was found to heal well during postoperative follow ups. In conclusion, we found that combinatory application of negative pressure wound therapy with rectus abdominis myocutaneous flap transfer could effectively control wound infection, promote the shedding of necrotic tissue, and accelerate wound healing.