Destructive necrotic processes of the sternum's bone-cartilaginous complex at infectious and inflammatory complications after surgical operations on open heart

The features and severity of destructive-necrotic processes of the bone-cartilage complex of the sternum in various clinical forms of infectious and inflammatory complications arising after open-heart surgery have been studied. It has been established that in patients with a diagnosis of instability of the sternum, pathological changes in the bone tissue of the sternum develop in the area of the longitudinal incision. They are characterized by lesions of the bone marrow, impaired blood supply, the formation of foci of suppuration and necrosis of bone tissue. In patients with diagnoses of “osteomyelitis and sternomediastinitis,” destructive-necrotic processes spread to various parts of the bone and cartilage apparatus of the sternum, accompanied by the development of centers of complete bone destruction, the formation of sequestrum and fistulous passages. In some cases, the purulent process extends to the pleura and mediastinum. The etiopathogens of the most pronounced pathological processes were Staphylococcus aureus and Pseudomonas aeruginosa.