Single-stage management of 74 consecutive sternal wound complications with pectoralis major myocutaneous advancement flaps.

Abstract:

:The optimal management of sternal wound complications remains controversial. Since 1985, we have utilized a combination of immediate, aggressive debridement with simultaneous repair using bilateral pectoralis major myocutaneous advancement flaps, regardless of the degree of infection. As compared with the use of distant pedicled muscle flaps or pectoralis major turnover flaps, the management of complicated sternal wounds with immediate pectoralis major myocutaneous advancement flaps provides an effective yet simpler, quicker method of management with improved aesthetic results. In addition, basing the pectoralis major myocutaneous flaps on the thoracoacromial arteries eliminates the need for intact internal mammary arteries, valuable since the latter are increasingly used for coronary grafts. Seventy-four consecutive patients, 17 (23 percent) of whom were immunosuppressed heart transplant recipients, have been managed with this procedure. There were no intraoperative deaths. The 30-day perioperative mortality rate was 9 percent (7 of 74), with only 1 death related to persistent sepsis. The morbidity rate was 39 percent, with the most common complication being seroma managed by needle aspiration (18 of 74, 24 percent). The aesthetic and functional results have been uniformly excellent.

journal_name

Plast Reconstr Surg

authors

Hugo NE,Sultan MR,Ascherman JA,Patsis MC,Smith CR,Rose EA

doi

10.1097/00006534-199406000-00016

subject

Has Abstract

pub_date

1994-06-01 00:00:00

pages

1433-41

issue

7

eissn

0032-1052

issn

1529-4242

journal_volume

93

pub_type

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