Table 8 In 2020, plastic surgeons summarized the previous classification and management
From: Review on risk factors, classification, and treatment of sternal wound infection
Classification | Anatomical depth | Surgical procedure |
|---|---|---|
Type I | Deep sternal wound infection reaching the sternum without sternal instability | # surgical debridement +/- NPWT followed by wound revision and direct closure or using fasciocutaneous pectoral flap |
Type II | Sternal instability without infection | # debridement and primary sternal closure either standard rewiring /reinforced /plates |
Type III | Deep sternal infection with sternal instability with MINOR tissue/ bone loss (< 50%) | # debridement +/- NPWT followed by primary sternal closure/direct or using fasciocutaneous pectoral flap or pectoralis muscle flap |
Type IV | Deep sternal infection/mediastinitis and MAJOR bone loss (> 50%) | #debridement/NPWT/Delayed primary closure (> 72 h) In #upper sternal defects: pecto-ralis major flap # lower or whole sternum defect: Pedicled rectus abdominis or great omentum |