Pectoralis major muscle flap combined with negative pressure lavage repaired the wound after thoracotomy
10.3969/j.issn.1673-9701.2024.13.013
- VernacularTitle:胸大肌肌瓣联合负压灌洗修复开胸术后伤口
- Author:
Fei HAN
1
;
Hao GUAN
;
Wanfu ZHANG
;
Jingqun ZHANG
;
Ruiyu LIU
Author Information
1. 空军军医大学第一附属医院烧伤外科,陕西西安 710032
- Keywords:
Refractory wound;
Pectoralis major muscle flap;
Negative pressure lavage
- From:
China Modern Doctor
2024;62(13):47-50
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the therapeutic effect of pectoralis major muscle flap combined with negative pressure lavage in one-stage repair of refractory wounds after thoracotomy.Methods From January 2020 to January 2023,21 patients with refractory wounds after thoracotomy were retrospectively selected from the First Affiliated Hospital of Air Force Military Medical University,including 16 males and 5 females,aged 35 to 75 years old,with an average age of(62.2±11.3)years old.The wound area was 6cm×3cm to 25cm×5cm.The infected sternum was removed.According to the location and size of the residual cavity,the pectoralis major muscle of the corresponding segment on both sides of the free wound was sutured and filled.The irrigation tube was reserved below the muscle flap.After the muscle flap covered the residual cavity,the skin around the wound was sutured without tension,and the negative pressure suction of-30 to-20 kPa was given.From the first day after operation,physiological saline was used for lavage,2000ml per day.The character,color and amount of lavage fluid and the systemic symptoms of patients were observed.After the lavage fluid was clear,the tube and the negative pressure device were removed.The wound was changed once every other day,and the stitches were removed 2 weeks after operation.Results Nineteen patients achieved primary healing within 14 days after operation.Two patients had scattered wounds of about 1 cm×1 cm in size,and continued dressing change.All patients healed one month after operation.The patients were followed up for half a year to 2 years.The patient's chest shape was beautiful.There was no effect on the activity of the forebody and upper limbs,and there was no significant change in the muscle strength of the upper limbs.Conclusion For the refractory wounds after thoracotomy,after removing the infected sternum,using the pectoralis major muscle flap combined with negative pressure lavage to close the wound in one stage can reduce the risk of wound infection and death,shorten the hospital stay of patients,and the operation is simple and the trauma to patients is less.
