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Schreiner et al. Plast Aesthet Res 2018;5:32 I http://dx.doi.org/10.20517/2347-9264.2018.45 Page 3 of 6
A B
Figure 1. A: The scheme of "en bloc" SCJ resection involving the median third of clavicle; B: first and second rib and partial resection of
manubrium combined with defect closure by contralateral pectoral muscle flap. SCJ: sternoclavicular joint
A B
Figure 2. Rib osteolysis and mediastinitis extending to the neck on computed tomography scan (white arrow) and ascites according to
liver insufficiency (red arrows)
A B
Figure 3. A: “J-shape” incision over sternal notch for extended debridement and necrectomy; B: well granulated wound after NPT in the
left sternoclavicular joint and delayed defect closure with contralateral pectoral muscle flap. NPT: negative pressure therapy
DISCUSSION
There is only a little published evidence on SCJ infection in association with the liver insufficiency. Only
one study and a case report describing in total 6 cirrhotic patients managed with open drainage and a pack-
[2,5]
ing are available to date . The SCJ infections in the cirrhotic patients are debilitating and associated with
[5]
surgical morbidity rate of up to 40% . Compromised immunity in the liver cirrhotic patients contributes to
