About Curtis J. Edwards, MD, FACS Expertise Can answer general and vascular surgery questions, trauma, burns, some plastic surgery questions, general gastrointestinal surgery and gastrointestinal medical questions and questions regarding aviation medicine.
Experience Board certified general surgeon. Seventeen years practice experience in general, vascular, and no-cardiac thoracic surgery and endoscopy.
Organizations College of Surgeons, AMA, Aerospace Medical Assoc., Civil Aviation Medical Assoc.
Education/Credentials BA, MD, American Board of Surgery, Fellow American College of Surgeons, seventeen years practice all phases, including teaching.
Question had quadruple bypass surgery in June 2006. my sternum did not heal. i was referred to a plastic surgeon and was operated on in February 2007 to have 4 titanium plates inserted to stabilize the sternum. it is now march 2008 and my sternum is still not healed. i am limited to lifting no more than 10 pounds and avoiding certain movements. will i ever be able to go back to work. and will the sternum ever heal?
Answer I have not examined you reviewed the medical record, associated laboratory studies, or imaging. What follows is offered to you for information purposes, only and does not constitute treatment. I advise an examination from a qualified healthcare professional before undertaking any course of treatment.
Sternal non union is more common in patients who have an internal mammary graft or grafts to the heart. The sternum may be deprived of needed blood flow to heal and fight infection. Sternal dehiscence is a problem late in the course of patient recovery for the reasons you mention.
The goal of reconstruction is bone apposition and stabilization. The titanium plates did not work, possibly because the bone is relatively ischemic.
You may need a flap procedure. A flap of skin is raised and rotated into place, sometimes with the underlying muscle, in order to bring vascularized tissue into place. This new tissue will assist in the healing process.
I recommend a second opinion obtained at a major teaching university plastic and reconstructive surgery program. The professor you want to see should be an expert in rotation and free flaps. The university should also have an active cardiovascular program where the problem will develop with some frequency. This keeps the plastic surgeons sharp by revisitng the problem. I hope this helps.
