Results of omental flap transposition for deep sternal wound infection after cardiovascular surgery.

Abstract:

OBJECTIVE:Our experience with omental flap transposition in the treatment of deep sternal wound infections is reviewed here with an emphasis on efficacy, risk factors for in-hospital mortality rates, and long-term results. SUMMARY BACKGROUND DATA:Even with improvements in muscle and omental flap transposition, the timing of closure and the surgical strategy are controversial. METHODS:Forty-four consecutive patients with deep sternal wound infections were treated using the omental flap transposition from 1985 through 1994. The strategies included debridement with delayed omental flap transposition or single-stage management, which consisted of debridement of the sternal wound and omental flap transposition. Methicillin-resistant Staphylococcus aureus was cultured from more than 50% of the wounds. A logistic regression analysis was used to identify the predictors of in-hospital death after omental flap transposition. RESULTS:There were seven (16%) in-hospital deaths. Univariate analysis demonstrated that hemodialysis and ventilatory support at the time of omental flap transposition were significantly associated with in-hospital mortality rates (p = 0.0023 and p = 0.0075, respectively). Thirty-seven patients whose wounds healed well were discharged from the hospital. Two patients with cultures positive for methicillin-resistant Staphylococcus aureus had recurrent sternal infections. Patients without positive methicillin-resistant Staphylococcus aureus cultures had good long-term results after reconstructive surgery. CONCLUSIONS:Transposition of an omental flap is a reliable option in the treatment of deep sternal wound infections, unless the patients require ventilatory support or hemodialysis at the time of transposition.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Yasuura K,Okamoto H,Morita S,Ogawa Y,Sawazaki M,Seki A,Masumoto H,Matsuura A,Maseki T,Torii S

doi

10.1097/00000658-199803000-00019

subject

Has Abstract

pub_date

1998-03-01 00:00:00

pages

455-9

issue

3

eissn

0003-4932

issn

1528-1140

journal_volume

227

pub_type

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