Which surgical management is indicated for infection of costal cartilage and the xiphoid process?

Which surgical management is indicated for infection of costal cartilage and the xiphoid process?

• A. Resection of involved cartilage and adjacent bony structures
• B. Antibiotics alone
• C. Simple drainage
• D. Lobectomy

Answer: (A)

Infection of costal cartilage and the xiphoid process requires source control because cartilage is largely avascular, so antibiotics have limited penetration into infected, necrotic tissue. The best approach is to remove all infected cartilage plus any adjacent involved bone to eradicate the nidus of infection and prevent ongoing osteomyelitis or chest wall sepsis. Merely draining pus or relying on antibiotics alone often fails because the infected cartilaginous tissue remains, continuing to harbor bacteria. Removing the involved cartilage and nearby bony structures provides definitive clearance and allows healing of the chest wall. Options focused on lung tissue or simple drainage do not address the primary infected site of the chest wall.

Infection of costal cartilage and the xiphoid process requires source control because cartilage is largely avascular, so antibiotics have limited penetration into infected, necrotic tissue. The best approach is to remove all infected cartilage plus any adjacent involved bone to eradicate the nidus of infection and prevent ongoing osteomyelitis or chest wall sepsis. Merely draining pus or relying on antibiotics alone often fails because the infected cartilaginous tissue remains, continuing to harbor bacteria. Removing the involved cartilage and nearby bony structures provides definitive clearance and allows healing of the chest wall. Options focused on lung tissue or simple drainage do not address the primary infected site of the chest wall.