Transposition of greater omentum for treatment of median sternotomy wound dehiscence

ABSTRACT

Sternal osteomyelitis after median sternotomy for cardiac surgery is associated with considerable morbidity and mortality. The ideal reconstruction after sternal debridement is still debated. Between January 2004 and July 2008, we treated 12 patients for sternal osteomyelitis with wound dehiscence after median sternotomy for cardiac surgery. Extensive debridement of the sternum were performed in all cases. The defect was covered by omental transposition followed by split-thickness skin graft 7-10 days later. Two-stage procedure was employed in all patients. Hospital stay ranged from 21 to 45 days. Five patients had previous muscle flaps. Partial necrosis of the omental flap occurred in one case. There was total resolution of the sternal infection in all patients. No recurrence of dehiscence was observed during 6 to 24 months of follow-up. Extensive d‚bridement along with omental flap transposition provides definitive control of the infection in cases of failure of other conservative or surgical interventions of median sternotomy wound dehiscence