New technique of pectoral muscle flap reconstruction for 23 patients with deep sternal wound infections
10.7507/1007-4848.201703045
- VernacularTitle:肌瓣成形新技术治疗胸骨切口深部感染 23 例
- Author:
LIU Jifu
1
,
2
;
GAO Yongshun
2
;
LI Baocheng
3
;
XU Xiaobin
3
;
HUANG Shuo
3
Author Information
1. Department of Thoracic Surgery, Emergency Medical Center of Integration of Traditional and Western Medicine of Beijing Chaoyang, Beijing, 100023, P.R.China;
2. Department of Thoracic Surgery, Army General Hospital, Beijing, 100700, P.R.China
3. Department of Thoracic Surgery, Emergency Medical Center of Integration of Traditional and Western Medicine of Beijing Chaoyang, Beijing, 100023, P.R.China
- Publication Type:Journal Article
- Keywords:
Deep sternal wound infections;
pectoralis major muscle flap;
surgery;
thoracic reconstruction
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(4):321-324
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the effect of deep sternal wound infections（DSWIs）treated by the techniques of pectoral major muscular(PM) turnover and non-suture remain after the wound restitution. Method We retrospectively analyzed the clinical data of 23 patients with DSWIs in our hospital between June 2016 and December 2016. There were 13 males and 10 females at age of 4-73(54.5±19.5) years. There were 8 patients with concomitant diabetes mellitus and 1 patient with chronic obstructive pulmonary disease(COPD) and brain infarction. Eigteen patients were of type Ⅱ, 5 patients of type Ⅲ according to Pairolero’ classification in the DSWIs. Five patients were with remaining abscess cavity in the mediastinum by thoracic compute tomography(CT). Under general anesthesia the DSWIs debrided thoroughly. The PM elevated from the anterior pectoralis major fascia off subcutaneous tissue to lateral to anterior axillary line, the PM cutted off, then made to the muscle flap, turnover PM flap filled and fixed to sternal wound by lighten tensile suture, the subcutaneous tissue and skin sutured by cutting full-thickness. Results The sternal reconstruction after debridement of the sternal wound was used by bilateral PM flap in the 17 patients, unilateral PM in 6 patients. There were 21(91.3%) patients in stage Ⅰ healing, 2 patients deferment healing of local cut skin without reoperation. There were 22 patients with non-paradoxical breathing during the postoperation. One death resulted from multiple-organ failure of the concomitant disease. The average of hospital day was 10.6 days. The wound healing was good by chest CT at 1 month after the operation. Conclusion The sternal forming by the technique of the PM flap turnover, without remain of fremde stoffe in wound for DSWIs is distinctive method, evident effect.
