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Schreiner et al. Plast Aesthet Res 2018;5:32 Plastic and
DOI: 10.20517/2347-9264.2018.45 Aesthetic Research

Original Article Open Access

Extended sternoclavicular joint infections in
cirrhotic patients: staged interdisciplinary approach

with thoracic and plastic surgery

Waldemar Schreiner , Wojciech Dudek , Denis Iulian Trufa , Raymund E. Horch , Horia Sirbu 1
1
1
2
1
1 Department of Thoracic Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen 91054,
Germany.
2 Department of Plastic and Hand Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen
91054, Germany.
Correspondence to: Dr. Waldemar Schreiner, Department of Thoracic Surgery, University hospital Erlangen, Friedrich-Alexander-
University Erlangen-Nuremberg, Krankenhausstrasse 12, Erlangen 91054, Germany. E-mail: waldemar.schreiner@uk-erlangen.de

How to cite this article: Schreiner W, Dudek W, Trufa DI, Horch RE, Sirbu H. Extended sternoclavicular joint infections in cirrhotic
patients: staged interdisciplinary approach with thoracic and plastic surgery. Plast Aesthet Res 2018;5:32.
http://dx.doi.org/10.20517/2347-9264.2018.45

Received: 11 Jun 2018 First Decision: 23 Jul 2018 Revised: 30 Jul 2018 Accepted: 30 Jul 2018 Published: 29 Aug 2018

Science Editor: Raymund Engelbert Horch Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Aim: Sternoclavicular joint infection associated with liver cirrhosis is an uncommon condition and the optimal surgical
treatment is undefined.

Methods: Patients and methods: we retrospectively analysed data from six patients with sternoclavicular joint infections
and liver cirrhosis underwent between February 2008 and May 2018 a staged therapy using negative pressure therapy
followed by secondary "en bloc" joint resection and a pectoralis muscle flap (PMF) obliteration of the thoracic wall
defect.

Results: Four patients successfully underwent a transfer of the PMF. The surgical revision was required for relevant
bleeding in one and a tracheostomy was performed due to the prolonged intubation in another case. One patient died on
the fifth day after surgery due to a cerebral septic embolic ischemia and aortic endocarditis.

Conclusion: The presence of liver insufficiency and coagulopathy was associated with an extensive blood product
demand and required a well-balanced interdisciplinary management. During the follow-up only a minimal restriction in
the shoulder mobility was observed.

Keywords: Liver cirrhosis, negative pressure therapy, pectoralis muscle flap, sternoclavicular joint infection

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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and indicate if changes were made.

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