A rational approach to sternal wound complications.

A large prospective study of over 350 sternal wound problems is used to help establish evaluation and treatment options to successfully treat this complication. The initial evaluation includes history, physical examination, CT scans, and intraoperative evaluations. Reconstructive options include conservative local therapies (125 patients), rewiring (30 patients), and muscle flap reconstructions (205 patients). The patients were collected over a 9-year period (1990-1999) and treated by a single reconstructive surgeon. Follow-ups for all patients has been at least 2 years (range 2-11 years), and greater than 90% obtained a healed wound at 3 months. Of the patients treated with muscle flap reconstructions, 95% are alive and healed at a 2-year follow-up.