Transsternal thoracotomy - normal postoperative appearance

Case contributed by Dr René Pfleger

Presentation

S/p median sternotomy 3 days before. Focal erythema and serous discharge at surgical site. No fever or increased leukocyte count. Sternal instability at clinical examination.

Patient Data

Age: 70
Gender: Male

S/p median sternotomy with normal postoperative findings including sternum with only minimal step-offs and a localized retrosternal fluid collection with a distinct margin. The majority of the mediastinal fat planes are preserved. There are no fluid collections or gas bubbles deep within the incision in the presternal soft-tissues.

Modality: Annotated image

As stated below.

Case Discussion

Bacterial wound culture obtained from incision site: No growth of any pathogenic organism. Vacuum assisted closure of the superficial sternal wound was applied and the patient made an uneventful recovery.

Key points:

  • median sternotomy, the most commonly used incision for open cardiac surgery, carries a 0.5-5% risk of serious complications
  • sternal dehiscence is a common precursor to deep sternal wound infection (mediastinitis)
  • CT is the modality of choice in evaluation of complications after sternotomy
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Case Information

rID: 34767
Case created: 8th Mar 2015
Last edited: 21st Jul 2016
System: Chest
Inclusion in quiz mode: Included

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