CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds

BACKGROUND: We examined the use of CO2 laser sterilization in the surgical treatment of infected median sternotomy wounds. Deep wound infection after median sternotomy is infrequent (1% to 5% of all cases) but is associated with significant morbidity, mortality, and cost. METHOD: Twenty-four consecutive patients with median sternotomy wound infection were treated by one plastic surgeon using a CO2 laser to sterilize wounds after debridement and before flap closure. The rectus abdominis muscle flap was primarily used, but the choice of muscle flap was case dependent. RESULTS: To date, no patient in this series has had postoperative wound infection, breakdown, or flap loss. One patient did have superficial skin loss. CONCLUSION: Although the morbidity rate was 17%, all patients had intact wounds. None of the 5 deaths was related to wound infection. We found that CO2 laser sterilization in the surgical treatment of sternal wound infections decreased morbidity, mortality, and cost.