Sternal Dehiscence Reconstruction Workup

Updated: Jul 18, 2022
  • Author: Mark A Grevious, MD, FACS; Chief Editor: Jorge I de la Torre, MD, FACS  more...
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Laboratory Studies

See the list below:

  • Obtain aspiration of fluid collections for culture and analysis.

  • Obtain wound cultures if clinical deterioration of the patient or further signs of breakdown are observed (ie, increased erythema, drainage, separation of incision).

  • Wound cultures should include quantitative microbiology count, tissue specimen for analysis, and sternal bone biopsies for culture.

  • Obtain a CBC with differential, blood cultures, C-reactive protein levels.

  • Prealbumin and transferrin levels are often important in preoperative nutrition assessment.


Imaging Studies

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  • Plain radiographs (anteroposterior [AP] or posteroanterior [PA]) may detect air in the mediastinum; a sternal stripe reflects air between separated sternal halves.

  • Ultrasonography may be performed.

  • CT scanning can accurately detect sternal disruption, pockets of fluid, abscess, or pleural effusions.


Other Tests

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  • MRI can be used to diagnose osteomyelitis or other pathologic processes (eg, recurrent tumor).

  • Bone scans to determine osteomyelitis may have a limited value for the acute wound because of the presence of inflammation and tracer uptake.

  • Bone cultures more accurately assist in making the diagnosis of osteomyelitis in the clinical setting.