PMID: 15385766Sep 24, 2004Paper

Split pectoralis major flaps for mediastinal wound coverage: a 12-year experience

Annals of Plastic Surgery
Edward N LiRonald P Silverman

Abstract

Poststernotomy mediastinitis is an infrequent but highly dangerous complication following median sternotomy. Typically, such wounds are debrided aggressively of necrotic and foreign materials with subsequent flap reconstruction. Between December 1989 and January 2002, 69 patients were referred to the University of Maryland division of plastic surgery for mediastinal wound coverage. A total of 105 flaps of various types were used. Fifty-eight percent of the patients received a single flap. Ninety percent of the flaps used were pectoralis major flaps, whereas only 10% of the flaps were rectus abdominis, latissimus dorsi, or omentum flaps. Ten patients (14.5%) required reoperation. The most common comorbidity was diabetes mellitus. Those patients with diabetes mellitus were 9.1 times more likely to require reoperation after their sternal reconstruction compared with nondiabetic patients (95% confidence interval, 2.1-40.4). Four patients (5.8%) died less than 30 days from their flap procedure. The flap of first choice used in this series is the pectoralis major turnover flap, which is harvested in its entirety and split in the direction of its muscle fibers. Taking the entire muscle allows better coverage of the lower portion of th...Continue Reading

References

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Citations

Jun 3, 2016·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·J P BeierR E Horch
Jun 3, 2014·Archives of Plastic Surgery·Ichiro HashimotoHideki Nakanishi
Jun 27, 2017·Annals of Plastic Surgery·Francesco CiancioAurelio Portincasa
Nov 20, 2018·Scandinavian Cardiovascular Journal : SCJ·Heidi-Mari P MyllykangasLeena T Berg
Jul 8, 2010·Annals of Plastic Surgery·Amy StumpRonald P Silverman
Jan 5, 2012·Annals of Plastic Surgery·Hamid R ZahiriDevinder P Singh
Aug 29, 2019·Microsurgery·Keiichi GoishiIchiro Hashimoto
Jul 9, 2016·Annals of Plastic Surgery·Sanne MolenkampPaul M N Werker
Jul 16, 2008·Plastic and Reconstructive Surgery·Robin J EvansDonald H Lalonde
May 7, 2009·The Laryngoscope·Stewart C LittleStephen S Park
Nov 4, 2017·Journal of Cardiothoracic Surgery·Pankaj Kaul
Jul 14, 2012·Annals of Plastic Surgery·Hamid R ZahiriDevinder P Singh
Sep 7, 2021·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·Heidi-Mari MyllykangasLeena T Berg

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