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Safety of neonatal sternal wound reconstruction after open heart surgery
  1. Venus Barlas1,
  2. Barkat Ali2 and
  3. Anil Shetty2
  1. 1School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
  2. 2Department of Surgery, Division of Plastic and Reconstructive Surgery, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
  1. Correspondence to Dr Barkat Ali; bali{at}


An open sternal wound is a dreaded complication after open heart surgery for neonatal congenital cardiac anomalies. Vascularised muscle flap reconstruction of sternal wound defects, to prevent life-threatening mediastinal infections, is the standard of care in adults and children. However, there is paucity of published literature regarding the safety of this technique in neonates. We describe a successful operative technique for complex reconstruction of an open heart sternal defect on a neonatal male patient. On 6 months postoperative follow-up, we identified an issue with sternal instability. Patient underwent a subsequent operation for reinforcement of the sternal wound repair with Vicryl mesh. The authors report safety of using three separate vascularised muscle flaps in a single neonatal operation. Long-term follow-up of the sternal wound reconstruction is warranted to determine need for secondary procedures.

  • plastic and reconstructive surgery
  • paediatric surgery
  • cardiothoracic surgery

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  • Contributors VB helped with manuscript writeup. BA helped with manuscript write up editing, obtaining patient consent, patient pictures and drawing illustrations. AS was the surgeon who performed the procedures and helped with conceptualisation and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.