Resection and Individualized Chest Wall Reconstruction for Sternal Osteochondroma Complicated by Superficial Postoperative Wound Infection: A Case Report

AIM: Sternal resection for sternal tumors may result in complex, full-thickness anterior chest wall defects. Chest wall reconstruction in this setting remains surgically challenging, with postoperative wound infection and prosthesis exposure representing common and troublesome complications. This case report aimed to describe a multidisciplinary reconstructive strategy and the long-term clinical outcome of a patient with a complex sternal defect. CASE PRESENTATION: A 48-year-old female patient with locally aggressive benign sternal osteochondroma underwent extended en bloc sternal tumor resection, resulting in a 10 × 12 cm chest wall defect. She underwent combined reconstruction using titanium mesh fixation, an omental flap, and bilateral pectoralis major muscle advancement flaps. Superficial wound infection with methicillin-resistant staphylococcus epidermidis (MRSE) occurred on postoperative day 14 without deep prosthesis infection. RESULTS: The patient was treated with thorough debridement, standardized vacuum-assisted closure (VAC) therapy, and targeted antibacterial treatment with linezolid. The wound infection was completely controlled, microbiological sampling from the prosthesis interface remained negative, and secondary flap repair achieved complete wound healing. During more than four years of clinical follow-up, no prosthesis removal, tumor recurrence, or severe complications were reported, and thoracic wall function remained intact. CONCLUSIONS: Multidisciplinary collaboration between thoracic surgery, plastic surgery, and oncology teams may be beneficial for complex sternal tumor resection and reconstruction. In this case, the integrated strategy combining rigid titanium mesh skeletal support, dual-flap soft-tissue reconstruction, and VAC wound care was associated with successful wound healing and prosthesis preservation despite postoperative superficial wound infection, suggesting its potential feasibility in selected patients.