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

Ben Jmaà Hèla1*, 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: [email protected]
 

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.

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Figure 1: Intraoperative photographs.

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Figure 2: Intraoperative photographs.

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Figure 3: Intraoperative photographs.

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Figure 4: Intraoperative photographs.

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Figure 5: Intraoperative photographs.

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