I used Multidex in the past (greater than 12 years ago). It was effective in wound care. I did not use in sternotomy wounds due to concerns about migrating dressing particles or reside left in the wound.
If you used a dressing liner, it may make removal and control of dressing particles more manageable.
Honestly, I have not seen the Multidex dressing marketed in the US for many years.
Consider an alginate or a hydrogel gel packing for the area once the infection is under control.
IN my practice I have used silver sulphadiazine (Silvadene) impregnated into gauze strips to pack the area and get the infection under control prior to other types of moist wound healing.
One key healing strategy is to maintain the wound base and edges moist will support healing and prevent premature or partial wound closure .
We do not have experience of using Multidex in sternotomy wounds, however found good results in other deep non healing wound like post op, eschartomtomy wound, gun shot wound. We found give good results by using Multidex when the area is clean. In infected/necrotizing cavitating wound the use of AQUACELE (Silver Impregnated) Ribbon appears to be more appealing. Once area is clean than Multidex is a good option.
I totally agree with the ribbon approach. We use that technique to ensure that all dressing material that is placed into the wound, is removed! If packing is left behind, you have done harm and advanced the problem. Packing ribbon or strips are the same just using a different name.
One cautionary note with packing...use caution to NOT over pack the wound or pack tightly. That causes ischemia to the wound cavity. One approach is to moisten the packing prior to filling it into the wound. If the material is packed when moist, it is difficult to over pack the cavity.
If using an alginate (rope) opening up a gauze 4x4 and loosely laying into the cavity before you place the ropes will also help in loose packing but also decrease the potential for leaving dressing remnants behind.
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