Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence

نویسندگان

  • Grazielle de Souza Horácio
  • Pedro Soler Coltro
  • Antonio Albacete Neto
  • Juliano Baron Almeida
  • Vinícius Zolezi da Silva
  • Ivan de Rezende Almeida
  • Alfredo José Rodrigues
  • Jayme Adriano Farina Junior
چکیده

OBJECTIVE This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. METHODS A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. RESULTS During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. CONCLUSION The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Our experience with pectoralis major flap for management of sternal dehiscence: A review of 25 cases

OBJECTIVE To report our experience of the pectoralis major flap as the treatment modality for post coronary artery bypass sternal wound dehiscence. MATERIALS AND METHODS A retrospective study of 25 open heart surgery cases, performed between January 2006 and December 2010 at Deenanath Mangeshkar Hospital, Pune, was carried out. Unilateral or bilateral pectoralis major muscle flap by the doubl...

متن کامل

The extended myocutaneous pectoralis major flap: A new tool for the successful coverage of the lower third in sternal dehiscence

Sir, Sternal dehiscence is one of the most common complications after median sternotomy, with an incidence of 0.2%–10%.[1‐3] The pectoralis major (PM) flap has achieved considerable success for its treatment, and many authors advocate its utilisation as first choice for sternal dehiscence reconstruction.[3] However, its deficiency in providing coverage to the lower third of the sternum is a com...

متن کامل

Management of deep sternal wound infections; placed in perspective!

[1] van Wingerden JJ, Lapid O, Boonstra PW, de Mol BAJM. Muscle flaps or omental flap in the management for deep sternal wound infection. Interact CardioVasc Thorac Surg 2011;13:179–188. [2] Matros E, Aranki SF, Bayer LR, McGurk S, Neuwalder J, Orgill DP. Reduction in incidence of deep sternal wound infections: random or real? J Thorac Cardiovasc Surg 2010;139:680–685. [3] Raja SG, Berg GA. Sho...

متن کامل

Pectoralis Muscle Flap Repair Reduces Paradoxical Motion of the Chest Wall in Complex Sternal Wound Dehiscence

BACKGROUND The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. METHODS In a propensity score matching analysis, ou...

متن کامل

Use of the pectoralis major fasciocutaneous flap in the treatment of post sternotomy dehiscence: a new approach Utilização do retalho fasciocutâneo do músculo peitoral maior na deiscência de esternotomia: uma nova abordagem

Conflict of interest: none. ABSTRACT Objective: To describe a new surgical technique for the treatment dehiscence after median thoracotomy transsternal using fasciocutaneous flap composed of the pectoralis major fascia. Methods: Between January 2009 and December 2010, from 1,573 patients submitted to coronary artery bypass graft, 21 developed wound dehiscence after sternotomy and were treated w...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 32  شماره 

صفحات  -

تاریخ انتشار 2017