Name of the Procedure:

Anesthesia for Sternal Debridement (Commonly referred to as Sternal Debridement Anesthesia)

Summary

Sternal debridement is a surgical procedure to remove infected, dead, or damaged tissue from the sternum (breastbone) to help promote healing. The anesthesia used during this procedure ensures that the patient remains pain-free and unaware during surgery.

Purpose

This procedure addresses infections, non-healing wounds, or other complications associated with the sternum often following cardiac surgery. The primary goal is to eliminate the diseased tissue, prevent the spread of infection, and promote a favorable environment for healing.

Indications

• Deep sternal wound infections.
• Chronic osteomyelitis of the sternum.
• Non-healing sternal wounds post-cardiac surgery.
• Severe chest pain or discomfort attributable to sternal infections.

Preparation

• Patients are often advised to fast (no food or drink) for at least 8 hours before the procedure.
• Adjustment or cessation of certain medications as directed by the healthcare provider.
• Pre-operative diagnostic tests, including blood work, ECG, and imaging studies to assess the sternum.

Procedure Description

1. Anesthesia Administration: General anesthesia is administered through an IV line, inducing sleep and ensuring the patient remains unconscious and pain-free.
2. Surgical Prep: The chest area is sterilized to reduce the risk of infection.
3. Incision and Debridement: The surgeon makes an incision over the sternum to access the infected or damaged tissue, which is then carefully removed.
4. Closure: Depending on the extent of the debridement, the incision is either closed with sutures or left open and packed for better drainage.
5. Monitoring: Continuous monitoring of vital signs throughout the procedure.

Duration

The procedure typically takes 1 to 3 hours, depending on the extent of the infection and the amount of tissue that needs removal.

Setting

This procedure is usually performed in a hospital operating room.

Personnel

• Surgeons specialized in cardiac or thoracic surgery.
• Anesthesiologist to administer and monitor anesthesia.
• Surgical nurses and technicians.
• Post-operative care team.

Risks and Complications

• Infection.
• Bleeding.
• Adverse reactions to anesthesia.
• Respiratory complications.
• Potential for prolonged hospital stay due to wound healing requirements.

Benefits

• Removal of infected or necrotic tissue.
• Reduced risk of further infection.
• Alleviation of pain and other symptoms.
• Improved overall healing and recovery prospects.

Recovery

• Patients are typically monitored in a recovery room for several hours immediately post-surgery.
• Hospital stay could range from a few days to several weeks, depending on the extent of the procedure and patient recovery.
• Follow-up visits for wound care and monitoring healing.
• Restrictions on physical activity to allow proper healing.

Alternatives

• Antibiotic therapy: Less invasive but may not be sufficient for severe infections.
• Vacuum-assisted closure (VAC) therapy: Can be used for less severe sternal wounds.
• Hyperbaric oxygen therapy: Used to promote healing in certain cases.
• Each alternative has its own set of benefits and limitations, and suitability varies based on the patient’s condition.

Patient Experience

• Patients will be under general anesthesia and will not feel anything during the procedure.
• Post-operatively, patients might experience pain or discomfort managed with medications.
• Instructions on wound care, activity restrictions, and signs of complications to watch for will be provided.
• Recovery periods vary, and adherence to follow-up care is crucial for successful healing.