A heartmate 3 was implanted in a patient.A few weeks later, the pt required reoperation due to sternal dehiscence at the sternomanubrial joint requiring a sternal plate; operating room cultures were negative.Pt was discharged home, and presented a month later with pronounced erythema over the mediastinal incision; chest ct revealed loose screw tip protruding into the mediastinum.A month later, the pt underwent his second sternal debridement and was found to have deteriorated bone with abscesses; operating room cultures grew staph epidermidis and staph warneri.A third sternal debridement was performed a few weeks later in preparation for future pectoralis flap.Fourth sternal debridement was conducted on the next week to excise dead bone.Closure of the wound occurred a few weeks later via right pectoral flap, left pectoralis major myocutaneous flap, primary closure and incisional vacuum-assisted closure (vac) placement.
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