Management of non-healing sternotomy wounds in Loeys-Dietz syndrome.

Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder that often leads to delayed wound healing due to mutations affecting the extracellular matrix. We describe a case of a man in his 20s with LDS type 4 presenting with a non-healing sternotomy wound following valve-sparing aortic root surgery. Initial management with simple dressings failed with non-healing over a 10-month period, necessitating scar revision surgery with layered closure and incisional negative pressure wound therapy (NPWT) for a prolonged period. This approach resulted in wound healing after 6 months. Following a revisional valve replacement, a similar treatment led to healing within 2 months. This case highlights the effectiveness of prolonged NPWT in managing complex wounds in patients with LDS, emphasising the need for specialised wound care in individuals with genetic predispositions to poor wound healing.