Distal sternectomy for post-sternotomy chronic osteomyelitis

Sternal chronic osteomyelitis following median sternotomy is a severe complication of open cardiac surgery, presenting as purulent draining sinus tracts in patients with a closed sternal wound. First-line treatments are repeated curettages, conservative debridements, aggressive antibiotic therapy and the application of negative pressure to wound to accelerate the wound-healing process and promote granulation tissue formation, by using the vacuum-assisted closure device. Recalcitrant infections may require sternectomy and resection of all infected costal cartilages for complete eradication of the infection. Here we report a case of recalcitrant post sternotomy osteomyelitis treated by distal sternectomy and reconstruction by absorbable mesh.