Closure of infected sternal wounds with a unilateral rectus abdominis muscle flap in addition to bilateral pectoralis major myocutaneous advancement flaps |
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Authors: | L L Q Pu J B O’Connell T Takei R J Restifo C G Newton G R Sandberg |
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Institution: | (1) Division of Plastic Surgery, University of South Florida, Harbourside Medical Tower, Suite 4.30, 4 Columbia Drive, Tampa, FL 33606, USA e-mail:Ipu@com1.med.usf.edu Tel.: +813 259-0986 Fax: +813.259-0985, US;(2) Section of Plastic Surgery, Department of Surgery, Bridgeport Hospital and Yale University School of Medicine, Bridgeport and New Haven, CT, USA, US |
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Abstract: | We have recently added to our regimen a unilateral rectus abdominis muscle flap to cover the lower sternum and adjacent soft
tissues, in addition to bilateral pectoralis major myocutaneous advancement flaps for closure of infected sternal wounds.
Twenty patients underwent this procedure for closure of infected sternal wounds after initial débridement at our institutions.
There were no intraoperative deaths in this series, but three patients died of other medical conditions. Two patients developed
hematomas and one developed recurrent sternal wound infection after surgery; two had superficial wound infections and five
had minor wound problems (i.e., skin edge necrosis). All surviving patients (17/20, 85%) had healed sternal wounds with normal
chest contour and there were no instances of flap necrosis, sternal wound dehiscence, or abdominal wall hernia during the
follow-up (18–60 months). Based upon our experience, we recommend a unilateral rectus abdominis muscle flap in addition to
bilateral pectoralis major myocutaneous advancement flaps for selected patients with infected sternal wounds. This approach
provides reliable soft tissue coverage with acceptable morbidity and mortality in this high-risk patient population.
Received: 29 July 1998 / Accepted: 1 March 1999 |
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Keywords: | Sternal wound Pectoralis major myocutaneous flap Rectus abdominis muscle flap |
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