Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection.
Surg Today
; 46(4): 460-5, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26026811
ABSTRACT
PURPOSE:
Post-sternotomy deep sternal wound infection (DSWI) is a severe complication of cardiac surgery. The introduction of omental and muscle flaps has resulted in a significant decrease in morbidity and mortality. In this article, we present the findings for a series of 55 consecutive patients with DSWI treated using an alternative bi-pectoral musculofascial flap technique.METHODS:
The patients were stratified into two groups (one-or two-stage intervention). Patients with septic wounds initially underwent debridement and wound treatment, while vacuum therapy was used in a subset of the subjects. All patients were treated with wound debridement and bi-pectoral advancement flap reconstruction.RESULTS:
30-day mortality was 5.4%. Most patients (72%) were treated in two stages, while vacuum therapy was used in 20% of the patients. The mean number of hospitalization days was 8 and 12 for the one- and the two-stage groups, respectively. Reconstruction was successful in all but three patients, each of whom developed recurrent infection. No major morbidity was reported at a mean follow-up of 82 months with excellent functional and aesthetic outcomes.CONCLUSIONS:
Pectoralis-major muscle flaps remain relevant in the modern management of post-sternotomy mediastinitis. The addition of an omental flap should be considered in cases in which the lower sternum is involved. Prompt diagnosis and a meticulous surgical technique ensure favorable results for the majority of patients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Músculos Peitorais
/
Retalhos Cirúrgicos
/
Infecção da Ferida Cirúrgica
/
Procedimentos de Cirurgia Plástica
/
Esternotomia
/
Mediastinite
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Surg Today
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Grécia