Extended sternoclavicular joint infections in cirrhotic patients: staged interdisciplinary approach with thoracic and plastic surgery

作     者：Waldemar Schreiner Wojciech Dudek Denis Iulian Trufa Raymund EHorch Horia Sirbu 

作者机构：Department of Thoracic SurgeryUniversity Hospital ErlangenFriedrich-Alexander-University Erlangen-NurembergErlangen91054Germany Department of Plastic and Hand SurgeryUniversity Hospital ErlangenFriedrich-Alexander-University Erlangen-NurembergErlangen91054Germany 

出 版 物：《Plastic and Aesthetic Research》 (整形与美容研究（英文版）)

年 卷 期：2018年第5卷第8期

页      面：24-29页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Liver cirrhosis negative pressure therapy pectoralis muscle flap sternoclavicular joint infection 

摘      要：Aim: Sternoclavicular joint infection associated with liver cirrhosis is an uncommon condition and the optimal surgical treatment is undefined. Methods: Patients and methods: we retrospectively analysed data from six patients with sternoclavicular joint infections and liver cirrhosis underwent between February 2008 and May 2018 a staged therapy using negative pressure therapy followed by secondary en bloc joint resection and a pectoralis muscle flap (PMF) obliteration of the thoracic wall defect. Results: Four patients successfully underwent a transfer of the PMF. The surgical revision was required for relevant bleeding in one and a tracheostomy was performed due to the prolonged intubation in another case. One patient died on the fifth day after surgery due to a cerebral septic embolic ischemia and aortic endocarditis. Conclusion: The presence of liver insufficiency and coagulopathy was associated with an extensive blood product demand and required a well-balanced interdisciplinary management. During the follow-up only a minimal restriction in the shoulder mobility was observed.