THE MORPHOLOGY OF CHRONIC POSTSTERNOTOMY OSTEOMYELITIS OF THE STERNUM, WHICH DEVELOPED AFTER CARDIOSURGICAL INTERVENTIONS

Abstract

Discusses the pathological changes of bone tissue of the sternum in cardiac surgery patients with post-sternotomy chronic osteomyelitis of the sternum. It is established that in the pathological process involved informed of all the vessels and bone marrow of the sternum then the bone tissue. In the examined patients revealed the devastation of the bone marrow, accompanied by inflammatory exudative manifestations. Discovered damage to blood vessels, multiple foci of hemorrhage in the bone and muscle tissue, deposition of hemosiderin, a violation of hematopoietic function of bone marrow. A significant number of sequesters. Sequestered most of trabeculae inside the bone with the transition to the cortical plate. In 3 of 4 examined patients, they are mainly localized in the region of the surgical incision throughout its length. In some cases it was noted the defeat of the periosteum and muscle, which leads to the formation of fistulas. The result is a fistulous form of chronic osteomyelitis. On the basis of pathomorphological picture was revealed that 3 patients had the place exogenous mechanism of infection of the surgical field.