Τίτλος:
Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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. © 2015, Springer Japan.
Συγγραφείς:
Spartalis, E.
Markakis, C.
Moris, D.
Lachanas, E.
Agathos, E.A.
Karakatsani, A.
Karagkiouzis, G.
Athanasiou, A.
Dimitroulis, D.
Tomos, P.
Περιοδικό:
Cataract & Refractive Surgery Today
Λέξεις-κλειδιά:
adult; aged; Article; bi pectoral muscle flap; debridement; disease severity; esthetics; female; heart surgery; human; length of stay; major clinical study; male; mediastinitis; muscle flap; pectoralis major muscle; recurrent infection; sternotomy; sternum; surgical infection; surgical mortality; surgical technique; treatment outcome; vacuum assisted closure; vacuum assisted closure device; adverse effects; follow up; mediastinitis; pectoral muscle; procedures; reconstructive surgery; severity of illness index; sternotomy; surgical flaps; Surgical Wound Infection, Debridement; Female; Follow-Up Studies; Humans; Length of Stay; Male; Mediastinitis; Pectoralis Muscles; Reconstructive Surgical Procedures; Severity of Illness Index; Sternotomy; Surgical Flaps; Surgical Wound Infection; Treatment Outcome
DOI:
10.1007/s00595-015-1192-5
