Objective To investigate the surgical method and curative effect of treating chronic sternum osteomyelitis after cardiac surgery with repairing transfer of pectoralis major muscle flap. Methods The patients with chronic sternum osteomyelitis after cardiac surgery (n=56) were chosen from Jan. 2008 to Aug. 2014, and among them 36 with simple sternum osteomyelitis, 11 with sternum osteomyelitis accompanied by costal chondritis and 9 with sternum osteomyelitis accompanied by suppurative infection in mediastinum. During the cardiac surgery, complete debridement and removing source of infection were carried out, and enough pectoralis major muscle flap was transferred to fill sternum defect. Negative pressure drainage was applied continuously and sensitive antibiotics were administered for preventing infection after cardiac surgery. The clinical efficacy was observed and followed up. Results All patients were followed up for 4 m to 12 m (averagely 8 m). There were 51 patients (91.1%) with phase I healing of incision, 3 (5.3%) with a few secretion at drainage outlet and healed after dressing changes for 1 w, and 2 (3.6%) with poor incision healing and cured after cardiac surgery again. There were no patients with incision re-infection, formation of chronic sinus tract and recrudescence of sternum osteomyelitis. All patients had normal functions of upper limbs. Conclusion The curative effect of repairing transfer of pectoralis major muscle flap is reliable in treatment of sternum osteomyelitis after cardiac surgery without more incisions, which is suitable for clinical application.%目的：探讨利用改良胸大肌肌瓣转移治疗心脏外科术后慢性胸骨骨髓炎的手术方法及临床效果。方法入选2008年1月～2014年8月在北京军区总医院收治心脏外科术后出现慢性胸骨骨髓炎患者56例。其中单纯胸骨骨髓炎36例，胸骨骨髓炎伴肋软骨炎11例，胸骨骨髓炎伴纵隔内感染9例。术中彻底扩创清除感染源，充分游离胸大肌肌瓣，翻转填塞胸骨缺损。术后持续负压吸引，应用敏感抗生素预防感染。观察及随访患者术后临床效果。结果患者均获随访，随访时间4~12个月，平均随访8个月。51例（91.1%）患者切口Ⅰ期愈合；3例（5.3%）患者引流管切口处有少许分泌物，经换药1周后愈合；2例（3.6%）患者术后切口愈合不良，经再次手术痊愈。无切口再次感染及慢性窦道形成，胸骨骨髓炎无复发，上肢功能均正常。结论改良胸大肌肌瓣转移治疗心脏外科术后慢性胸骨骨髓炎效果可靠，无需增加切口，适宜临床推广应用。
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