Our Summary

This research paper seems to focus on dealing with deep infections that occur in the chest area, specifically after heart surgery. The main aspects discussed are the complications that can arise from these infections and various methods of treatment. This includes continuous irrigation - constantly flushing the wound with a fluid to clean it, and negative pressure wound therapy - using a vacuum to draw out fluid from the wound. Both methods are used to promote healing and prevent further infection. The paper also discusses the care provided before, during, and after surgery to minimize the risk of infection.

FAQs

  1. What is a sternotomy?
  2. What are some common complications of sternotomy?
  3. What is the role of continuous irrigation and negative pressure wound therapy in managing deep sternal wound infections?

Doctor’s Tip

One helpful tip a doctor might tell a patient about sternotomy is to avoid lifting heavy objects or engaging in strenuous activities that could put strain on the chest area while the sternum is healing. It is important to follow the doctor’s post-operative care instructions carefully to ensure proper healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended sternotomy are those who require cardiac surgery, such as coronary artery bypass grafting, valve replacement, or repair, as well as those who require access to the heart or great vessels for other procedures. This includes patients with complex heart conditions, congenital heart defects, or aortic dissections. Additionally, patients who have had previous sternotomies and require revision surgery may also be recommended sternotomy.

Timeline

Before sternotomy:

  • Patient is evaluated by a healthcare provider and deemed to require surgery involving a sternotomy.
  • Patient may undergo preoperative testing and preparation for the procedure.
  • Patient is taken to the operating room and undergoes general anesthesia.
  • Surgeon performs the sternotomy, which involves cutting through the breastbone (sternum) to access the chest cavity for various surgical procedures.
  • The surgical procedure is completed, and the sternum is typically closed with wires or sutures.

After sternotomy:

  • Patient is closely monitored in the postoperative recovery area for immediate complications.
  • Patient may be transferred to the intensive care unit for further monitoring and management.
  • Patient may experience pain, swelling, and discomfort at the site of the sternotomy incision.
  • Patient is started on a regimen of pain medications, antibiotics, and other medications as needed.
  • Patient is encouraged to perform deep breathing exercises and coughing to prevent respiratory complications.
  • Patient may undergo physical therapy to regain strength and mobility.
  • Patient is discharged from the hospital once deemed stable and able to continue recovery at home.
  • Patient follows up with healthcare providers for regular monitoring and care to prevent complications such as deep sternal wound infection.

What to Ask Your Doctor

  1. What is a sternotomy and why is it necessary for my treatment?
  2. What are the potential risks and complications associated with a sternotomy procedure?
  3. How long is the recovery time following a sternotomy?
  4. What can I expect in terms of pain management after a sternotomy?
  5. Will I need physical therapy or rehabilitation after the procedure?
  6. How can I care for my sternotomy wound to prevent infection?
  7. What signs or symptoms should I watch for that may indicate a complication with my sternotomy wound?
  8. Will I need any additional follow-up appointments or imaging studies to monitor my recovery?
  9. Are there any restrictions on activities or movements I should be aware of post-surgery?
  10. What can I do to promote healing and minimize scarring from the sternotomy procedure?

Reference

Authors: Kreibich M, Rylski B. Journal: Eur J Cardiothorac Surg. 2019 May 1;55(5):982-983. doi: 10.1093/ejcts/ezy462. PMID: 30649253