PMC3297043_01
A) Bilateral infection in the 3rd to 8th costal cartilages and ribs. B) 3rd to 8th bilateral costal cartilage removal. C) Second bilateral debridement of the 6th ribs on the 4th post-operative day. D) Final apperance of the wound with insertion of a Portovac  tube.
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The patient underwent aggressive surgical debridement by thoracic and plastic surgeons with the removal of steel stitches, which revealed bilateral infection in the 3rd to 8th costal cartilages (Figure 1A), which were partially removed (Figure 1B), and vacuum-assisted closure (VAC) was used. The subject remained on VAC until new surgical debridement was performed bilaterally on the 6th ribs four days later (Figure 1C). The VAC device was removed, a Portovac  tube was inserted, and the wound was closed primarily (Figure 1D).