Allergic to metal, Sternum won't heal

Question

I have a friend who had triple-bypass surgery over a year ago. He is allergic to any type metal, so in order to close him back up they used an alternative. The altenative was some type of surgical rope. His chest still moves. The doctors thought that scar tissue would eventuallly knit him back together, but failed. So far they have found nothing that they can use to correct this problem. Any metal at all is out of the question. You can actually feel his sternum move when you touch it. This tends to be very painful at times, especially when laughing or any quick movement. Are you aware of any alternative product that could be used to knit him back together? Remember no metal clips or anything can be left in.

This discussion is related to healing of sternum after bypass surgery.

ramblinrose322 · Answer

I am hoping you can help me as well. My mother is 62 and had a quad bypass in April 2009 along with complications including HIT syndrome and also a slight stroke. She was released about a month later but continued with a small wound to the lower sternal area. She went to Wound Care around 7/2009 and had a CT scan that supposedly came back without any noted pus pockets.  The radiology report dated 7/31/2009 that compares to the CT done 5/6/2009 says that there has been interval resolution of left lower lobe consolidation and pleural effusion. Minimal right basilar atelectasis is seen. Stranding and minimal amount of fluid is seen tracking along the sternum, new from 5/6/2009. There is mild erosion of the inferior sternum which is consistent with the clinical diagnosis of sternal infection. Sternal infection worse in the inferior aspect with bony erosion. However, the surgeon went ahead and did a debridement and closure of the sinus tract on 8/14/2009. He noted that there was no evidence of pus. There was an old suture granuloma in the region. Cultures wet taken and the wound was washed with antibiotic solution and then closed. Ever since then she has complained about never feeling right and felt that her bones sort of shift when she moves or breathes deep. Ever since the bypass she has had a large lump in the lower aspect of her sternum, which began to drain on 11/6/12. This is where I am trying to get answers!! She has type 2 diabetes mellitus, Rheumatoid arthritis, high cholesterol, coronary artery disease, COPD, vasculitis, peripheral neuropathy.... She was taken back for surgery on 11/9/12 for a small abscess incision & drainage. However, she came out with a hole in her chest the size of a tennis ball! They had to remove 3 wires from her CABG (which she told them in 2009 that she was allergic to metal), removed some cartilage and part of her lower sternum. My mother has no insurance, however, a wound vac was donated along with 6 home health visits. We went to the wound dr today and he said that the wound is not healing and advised to stop the wound vac. Now I am worried! Apparently she has two different infections in this wound. In your opinion what is her prognosis? I appreciate any information that you can offer as I have had to take a crash course in wound cleaning!

doctorarch · Answer

I am Dr. Arch Miller. I am on the reconstructive forum. Your friend can probably have titanium used on him as it is impossible to be allergic to that alloy. The "rope" that was used is likely a cable that is actually a metal. His sternum will never heal in its current state. I recommend that he see Dr. Scott Levin of Duke University, Dr. James Spann of Tulsa, Oklahoma or myself to consider having this fixed. Go to  the web site rapidsternalclosure.com and you will see a  very efficient way of dealing with this problem. We have done over 500 cases with great success and I feel that your friend would benefit from this. Feel free to contact me or the others at their offices to get further information or to see us. This problem can be fixed. One way to test for an allergy is to just tape some of the metal ton his skin. If he breaks out, then it is allergy, if not, then he is not allergic. I hope this helps,respectfully,
                    arch s miller ms md facs