Management of sternal wounds with bilateral pectoralis major myocutaneous advancement flaps in 114 consecutively treated patients: refinements in technique and outcomes analysis

摘要: Because life-threatening sternal wound complications can occur following sternotomy, the optimal management of infections remains an important topic. To decrease morbidity operative treatment these patients, authors made a number refinements in their protocol over past several years, particularly with regard to extent debridement, method flap apposition, and drains. The purpose this study was obtain specific outcomes data by reviewing large series patients treated single surgeon. In 114 consecutive wounds senior author (Ascherman), were managed almost exclusively debridement immediate closure bilateral pectoralis major myocutaneous advancement flaps. There no intraoperative deaths. 30-day perioperative mortality rate 7.9 percent, only one death directly related infection. Nineteen (16.7 percent) experienced postoperative morbidity, including partial dehiscences (5 percent), skin edge necrosis seromas (3.5 percent). advocate single-stage complicated procedure is rapid effective. Refinements technique have significantly lowered morbidity.