Successful management of absent sternum in an infant using porcine acellular dermal matrix
Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular derm...
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Korean Society of Plastic and Reconstructive Surgeons
2019-09-01
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doaj-133633a6ba9c4d839529e06889b21eab2020-11-25T02:47:35ZengKorean Society of Plastic and Reconstructive SurgeonsArchives of Plastic Surgery2234-61632234-61712019-09-0146547047410.5999/aps.2018.008293622Successful management of absent sternum in an infant using porcine acellular dermal matrixRoy Alfred Semlacher0Muhammand A.K. Nuri1 Department of Plastic and Reconstructive Surgery, Mary Bridge Children’s Hospital & Health Network, MultiCare Health System, Tacoma, WA, USA Seattle Children’s and Mary Bridge Children’s Regional Cardiac Surgery Program, Tacoma, WA, USACongenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood Creactive protein levels declined to ≤2 mg/L, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.http://www.e-aps.org/upload/pdf/aps-2018-00829.pdfSternumAcellular dermisSurgical meshThoracic surgeryNegative pressure wound therapy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Roy Alfred Semlacher Muhammand A.K. Nuri |
spellingShingle |
Roy Alfred Semlacher Muhammand A.K. Nuri Successful management of absent sternum in an infant using porcine acellular dermal matrix Archives of Plastic Surgery Sternum Acellular dermis Surgical mesh Thoracic surgery Negative pressure wound therapy |
author_facet |
Roy Alfred Semlacher Muhammand A.K. Nuri |
author_sort |
Roy Alfred Semlacher |
title |
Successful management of absent sternum in an infant using porcine acellular dermal matrix |
title_short |
Successful management of absent sternum in an infant using porcine acellular dermal matrix |
title_full |
Successful management of absent sternum in an infant using porcine acellular dermal matrix |
title_fullStr |
Successful management of absent sternum in an infant using porcine acellular dermal matrix |
title_full_unstemmed |
Successful management of absent sternum in an infant using porcine acellular dermal matrix |
title_sort |
successful management of absent sternum in an infant using porcine acellular dermal matrix |
publisher |
Korean Society of Plastic and Reconstructive Surgeons |
series |
Archives of Plastic Surgery |
issn |
2234-6163 2234-6171 |
publishDate |
2019-09-01 |
description |
Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood Creactive protein levels declined to ≤2 mg/L, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh. |
topic |
Sternum Acellular dermis Surgical mesh Thoracic surgery Negative pressure wound therapy |
url |
http://www.e-aps.org/upload/pdf/aps-2018-00829.pdf |
work_keys_str_mv |
AT royalfredsemlacher successfulmanagementofabsentsternuminaninfantusingporcineacellulardermalmatrix AT muhammandaknuri successfulmanagementofabsentsternuminaninfantusingporcineacellulardermalmatrix |
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1724752796158263296 |