ABSTRACT
To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18. 1 ± 3. 8)days vs. (36. 7 ± 11. 4) days], less hospital costs [(19429 ±4088)yuan vs. (33495 ±10712)yuan], less number of operations [(1. 1 ±0. 3)times vs. (2. 4 ±0. 8)times], higher level of satisfaction(56. 4％ vs. 30. 8％), lower relapse rate(5. 1％ vs. 26. 9％), the differences are statistically significant(all P <0. 05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.
ABSTRACT
Objective To evaluate the possible protective effect of isoflurane and propofol on myocardium during off pump coronary artery bypass grafting (CABG) surgery. Methods Twenty-six patients undergoing elective CABG without cardiopulmonary bypass were allocated into propofol group (n=13) and isoflurane group (n=13). Anesthesia was performed in propofol group with propofol plus fentanyl, while isoflurane and fentanyl were used in isoflurane group. Artery blood samples were collected before induction of anesthesia, and during and after the surgery. Plasma troponin I (cTnI), creatine kinase-MB (CK-MB), interleukin-6 (IL-6), and lactate concentrations were determined respectively. Results At the 4 hours after operation, plasma level of cTnI was significantly increased in both groups, and no significant differences were found between them. Compared with baseline values, IL-6 in propofol group showed no significant changes at each endpoint. However, IL-6 values in isoflurane group were significantly higher than those in propofol group during and after surgery (P