Post-traumatic sternal wound infection in a resource-constrained tertiary hospital: case report

  • I Ramkissoon Kimberley Hospital
  • A E Elliott Kimberley Hospital
  • A Nieuwoudt Kimberley Hospital
  • C L Faro Kimberley Hospital
  • W D Van Wyk Kimberley Hospital
  • Maria Gattorno Giaquinto-Cilliers Kimberley Hospital
  • J T Coetzee Kimberley Hospital
  • Y Naidoo Kimberley Hospital
  • K A Naidu Kimberley Hospital
  • R P Schulenburg Kimberley Hospital

Abstract

Sternal wound infections are mostly a result of complications of coronary artery bypass graft, post-trauma sternotomy, penetrating chest trauma and cardiopulmonary resuscitation. In South Africa the majority of rural hospitals are resource-constrained , and tertiary services and academic centres are overloaded with patients. The planning and execution of difficult cases may require a combination of ‘simpler’ techniques as shown in this case report. The authors’ approach for the surgical and reconstructive management of post-traumatic deep sternal wound infection was achieved with a combination of negative-pressure wound therapy (NPWT) and a split thickness skin graft (STSG), a deviation from the usual recommendations for management.

Author Biographies

I Ramkissoon, Kimberley Hospital
MBChB, Medical Officer, Department of Plastic and Reconstructive Surgery & Burns, Kimberley Hospital
A E Elliott, Kimberley Hospital
MBChB, Medical Officer, Department of Plastic and Reconstructive Surgery & Burns, Kimberley Hospital
A Nieuwoudt, Kimberley Hospital
MBChB, Medical Officer, Department of Plastic and Reconstructive Surgery & Burns, Kimberley Hospital
C L Faro, Kimberley Hospital
MBChB, Medical Officer, Department of Plastic and Reconstructive Surgery & Burns, Kimberley Hospital
W D Van Wyk, Kimberley Hospital
MCBhB, Medical Officer, Department of Plastic and Reconstructive Surgery & Burns, Kimberley Hospital
Maria Gattorno Giaquinto-Cilliers, Kimberley Hospital
MD, Specialist in Plastic Surgery (Brazil) and Head of Unit, Department of Plastic and Reconstructive Surgery and Burns, Kimberley Hospital
J T Coetzee, Kimberley Hospital
MBChB, Medical Officer, Department of Cardio-Thorax Surgery, Kimberley Hospital
Y Naidoo, Kimberley Hospital
MBChB, Medical Officer, Department of Cardio-Thorax Surgery, Kimberley Hospital
K A Naidu, Kimberley Hospital
MBChB, Medical Officer, Department of Cardio-Thorax Surgery, Kimberley Hospital
R P Schulenburg, Kimberley Hospital
MBChB, FC(Cardio), Head of Unit, Department of Cardio-Thoracic Surgery, Kimberley Hospital
Published
2018-07-17
Section
Wound Care