Reconstruction of the Chest Wall by a Myoplasty in the Treatment of Mediastinitis after Cardiac Surgery Caused by Klebsiella pneumoniae

Ben Jmaa Hela; Ghorbel Nesrine; Cherif Taieb; Hentati Abdessalem; Iyadh Ghorbe; Ben Jmaa Tarak; Masmoudi Sayda; Elleuch Nizar; Ennouri Khalil; Ben Jmaa Mounir; Frikha Imed

Reconstruction of the Chest Wall by a Myoplasty in the Treatment of Mediastinitis after Cardiac Surgery Caused by Klebsiella pneumoniae

Ben Jmaa Hela, Ghorbel Nesrine, Cherif Taieb, Hentati Abdessalem, Iyadh Ghorbe, Ben Jmaa Tarak, Masmoudi Sayda, Elleuch Nizar, Ennouri Khalil, Ben Jmaa Mounir, Frikha Imed

Ben Jmaà Hèla^1*, Ghorbel Nesrine¹, Cherif Taieb¹, Hentati Abdessalem¹, Iyadh Ghorbel², Ben Jmaà Tarak³, Masmoudi Sayda¹, Elleuch Nizar¹, Ennouri Khalil², Ben Jmaà Mounir³ and Frikha Imed¹

¹Department of Cardiovascular and Thoracic Surgery, Habib Bourguiba Hospital Sfax, Tunisia

²Department of Plastic Surgery, Habib Bourguiba Hospital Sfax, Tunisia

³Department of Infectious Diseases, Hedi Chaker Hospital Sfax, Tunisia

*Corresponding Author:: Ben Jmaà Hèla
Department of Cardiovascular and Thoracic Surgery
Habib Bourguiba Hospital Sfax, Tunisia
E-mail: helabenjemaa2015@gmail.com

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Clinical Presentation

Mediastinitis are among the most dreadful infectious complications following cardiac surgery. In most of the cases, the medical treatment associated with irrigation drainage is sufficient.

However, in case of severe sternal dehiscence, plastic surgery becomes necessary in order to fill up the loss with a well-vascularized tissue. We report the case of a 68-year-old patient, who presented, after a coronary artery bypass, a sternal dehiscence and necrosis with a Klebsiella pneumoniae mediastinitis, which was treated by bone resection and a myoplasty via reversal of the right latissimus dorsi muscle. The post-surgery course was favourable. Intraoperative photographs (Figures 1-5) are showing the taking of the right latissimus dorsi muscle and its reversal myoplasty into the sternal wound.