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冠状动脉搭桥术后胸骨切口感染裂开的修复
引用本文:匡斌,陈云瀛,邓国三,黄广香,赵成利,邝石峰,邓健,连继洪,谢文斌.冠状动脉搭桥术后胸骨切口感染裂开的修复[J].中国修复重建外科杂志,2006,20(7):732-734.
作者姓名:匡斌  陈云瀛  邓国三  黄广香  赵成利  邝石峰  邓健  连继洪  谢文斌
作者单位:广东省人民医院整形创伤科,广州,510080
基金项目:广东省人民医院科研项目
摘    要:目的介绍冠状动脉搭桥术后,胸骨切口感染裂开的手术修复方法。方法2002年2月~2004年10月,冠状动脉搭桥术后胸骨切口感染裂开患者10例,男7例,女3例。年龄68~76岁。创口范围3cm×5cm~5cm×15cm。经伤口扩创,坏死软组织及坏死胸骨、肋骨、肋软骨清除后,切取腹直肌肌皮瓣、胸大肌肌皮瓣、背阔肌肌皮瓣移位修复前胸伤口或单纯胸大肌肌瓣移位填塞死腔,消除创面,切取皮瓣范围3cm×5cm~5cm×16cm。结果术后10例患者伤口均期愈合。随访3~11个月,平均6个月,伤口无炎性表现,呼吸正常,无腹壁疝发生,上肢功能正常。无其他并发症出现,供区伤口愈合良好,临床效果满意。结论根据不同病程、局部炎性情况以及术中扩创后情况,分别选用不同的手术方式修复创面,可获得满意的治疗效果。

关 键 词:肌皮瓣  肌瓣  胸骨切口感染裂开  修复
收稿时间:2005-04-08
修稿时间:2005-09-19

RECONSTRUCTION OF INFECTED MEDIAN STERNOTOMY WOUND DEHISCENCE AFTER CORONARY ARTERY REVASCULARIZATION
KUANG Bin,CHEN Yunying,DENG Guosan,et al..RECONSTRUCTION OF INFECTED MEDIAN STERNOTOMY WOUND DEHISCENCE AFTER CORONARY ARTERY REVASCULARIZATION[J].Chinese Journal of Reparative and Reconstructive Surgery,2006,20(7):732-734.
Authors:KUANG Bin  CHEN Yunying  DENG Guosan  
Institution:Department of Plastic Surgery, Guangdong Provincial People's Hospital, Guangzhou Guangdong, PR China. kbdoc@163.com
Abstract:OBJECTIVE: To introduce the experience about the reconstruction of median sternotomy wound dehiscence. METHODS: From February 2002 to October 2004, 10 patients with median sternotomy wound dehiscence due to coronary artery revascularization were treated. There were 7 males and 3 females, aging from 68 to 76 years. The sizes of defects ranged from 3 cm x 5 cm to 5 cm x 15 cm. After debridement of necrotic soft tissue, sternum and rib, infected median sternotomy wound was reconstructed with rectus abdominis myocutanous flap, pectoralis major myocutanous flap and latissimus dorsi flap or single muscle flap. The sizes of flaps ranged from 3 cm x 5 cm to 5 cm x 16 cm. RESULTS: All patients were followed up from 3 to 11 months with an average of 6 months. All the patients achieved healing by first intention with normal respiration and normal function of upper limbs. The wound of donor site healed well. No abdominal hernia and other complications occurred. The wound of donor site healed well. The results were satisfactory. CONCLUSION: According to different stages of the disease and different conditions of an operation, the surgical management should vary with each individual.
Keywords:Myocutanous flap Muscle flap Infected median sternotomy wound dehiscence Reconstruction
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