Before/After Image

Post- Bypass Wound Breakdown

Patient Review

  • Patient's Name: Anonyms
  • Patient's Age: 65
  • Patient's Gender: female

Symptoms

  • Post- Bypass Wound Breakdown

Case Presentation

Heart Bypass surgery is a lifesaving procedure done following symptoms like a heart attack when it is diagnosed the blood supply to different parts of the heart is reduced due to the narrowing of blood vessels supplying blood to the heart.

For bypass surgery, the chest is opened in the midline and surgery is performed. Following this surgery, the wound may take a long time to heal, especially in women due to the weight of breasts stretching the suture line. In some patients, the wound does not heal and opens up exposing the underlying bone- sternum and other tissues. 

 

These wounds have the potential to become infected, hence, need to be treated early and diligently so as to prevent infection and promote healing. Such wounds are called sternal dehiscence or opening up of the sternal wound.

 

These patients are then referred to the Plastic Surgeon for wound management. The wound is managed in two or three stages. To begin with, the wound is evaluated for its depth, quantum and type of infection and presence of non-living tissues. A CT scan is performed routinely to assess all these. 

 

The first stage consists of cleaning up the wound and is called Debridement; following debridement the wound is closed with a special type of dressing called Negative pressure wound dressing wherein a vacuum is created to facilitate better healing.

 

As the wounding quality improves in 5-10 days, the patient is then taken up for definitive surgery. Most often than not, flap surgery is done to close the wound; wherein healthy tissue is taken from elsewhere in the body and used to fill the cavity of the wound and close it completely. This facilitates complete closure of the wound and optimal healing.

debriment surgery
fat tissue from abdomen

 

Case Study on Post Bypass Wound Breakdown:

Mrs A, aged 65years, presented to the Plastic Surgery OPD, two months after her coronary bypass surgery (CABG). Her complaints were an open wound with discharge and pain. She said, the suture line after bypass surgery appeared to be healing during the first week, but subsequently she noticed the wound open up in the lower end discharging some fluid and blood.

 

The upper end apparently continued to heal but the lower end opening seemed to go deeper towards the bone.

We counselled her for the need for a two-stage surgery to which she agreed.

 

The first stage was debridement – cleaning up the wound and removing all necrotic and unhealthy tissue. The second stage was covering the wound with a healthy flap taken from the abdomen. The wound then went on to heal uneventfully.

 

As the wounding quality improves in 5-10 days, the patient is then taken up for definitive surgery. Most often than not, flap surgery is done to close the wound; wherein healthy tissue is taken from elsewhere in the body and used to fill the cavity of the wound and close it completely. This facilitates complete closure of the wound and optimal healing.

 

Post-surgery 2 years and she is doing fine.

After Wound Healing

 

Treatment and prognosis

  • Post- Bypass Wound Breakdown
  • CT scan

Physical Examination & Tests

  • Post- Bypass Wound Breakdown

Relevant Questions

Q. Hello Dr, I am Soumil. I want to know what foods should I avoid before going plastic surgery? can you please suggest me??

Avoid high-fibre foods of any kind within 24 hours of any surgical operation involving anaesthesia, including fruits, vegetables, legumes, nuts, and whole grains. You should avoid eating fish or taking fish oil or omega-3 supplements for the two weeks coming up to surgery. For more information, you can book an appointment with Dr Leena Jain. 

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Q. Doctor I had a query, How to find out if I really need a breast augmentation?

Breast augmentation is a subjective desire. If a girl/woman feels her breasts are small then she can opt for an augmentation or implant surgery to increase the volume of her breasts. Hope this answer helps you!

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Q. Hello dr, will plastic surgery led to any problems in the future? I am worried about it.

No dear, it is like any other surgery. It involves all the steps and similarly also the risks involved in any other surgery. It is a common concern that plastic surgery especially poses problems in future, it’s not true.

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Q. Hello, I am a 33 year old female and looking for cosmetic surgeons who have expertise in fat grafting and wondering if that's one of the services you offer. The concerned area is my under eyes. I have hollow eyes. Thank You.

 Fat grafting, we do it regularly for breasts and for Scars. We can do it for hollow eyes also. Please call 9137767350 for appointments.

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Q. Hello. I am a 43-year-old woman. I have no pains, but I want to have breast reduction surgery for aesthetic purposes, improve my posture, and work out better. I am presently overweight, and my large breasts cause a lot of discomfort when I do active cardio exercises. Could you please advice?

Hello. Heavy breasts do cause a lot of back, neck and shoulder pain. The heaviness they cause on the chest causes breathlessness. Also, people start slouching due to the weight of breasts.

You can consider breast reduction surgery as it gives an immediate relief from all the above physical symptoms, improving your confidence and making you feel light.

For appointments kindly call or message on 9820991853/ 9137767350

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