Application of unilateral pectoralis major muscle flap in the treatment of sternal wound dehiscence
Rev. bras. cir. cardiovasc
;
32(5): 378-382, Sept.-Oct. 2017. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-897941
ABSTRACT
Abstract 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.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Músculos Peitorais
/
Retalhos Cirúrgicos
/
Deiscência da Ferida Operatória
/
Esternotomia
Tipo de estudo:
Estudo observacional
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
Cirurgia Geral
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Universidade de São Paulo/BR
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