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Use of the pectoralis major fasciocutaneous flap in the treatment of post sternotomy dehiscence: a new approach

机译:胸大肌筋膜皮瓣在胸骨后开裂治疗中的应用:一种新方法

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OBJECTIVE: To describe a new surgical technique for the treatment dehiscence after median thoracotomy transsternal using fasciocutaneous flap composed of the pectoralis major fascia. METHODS: Between January 2009 and December 2010, from 1,573 patients submitted to coronary artery bypass graft, 21 developed wound dehiscence after sternotomy and were treated with bilateral pectoralis major muscle fasciocutaneous flap, including partial portion of the rectus abdominis fascia. Patients were followed for a minimum of 90 days postoperatively. RESULTS: All patients had favorable outcome following 90 days, not having any partial or total dehiscence. There were no cases of postoperative infection. CONCLUSION: The procedure was rapid and effective. Compared with techniques using muscle, myocutaneous or greater omentum flaps, this surgery was less aggressive and maintained the integrity of tissue region. The authors considered that this technique should be used as the first option, leaving the flaps to more complex cases of relapse.
机译:目的:描述一种新的外科手术方法,该方法使用胸大肌筋膜组成的筋膜皮瓣治疗经胸骨正中胸骨后开裂。方法:2009年1月至2010年12月,在1,573例接受冠状动脉搭桥术的患者中,有21例在胸骨切开术后出现伤口裂开,并接受了双侧胸大肌筋膜皮瓣,包括腹直肌筋膜的一部分。术后至少随访90天。结果:所有患者在90天后均取得了良好的预后,没有出现部分或全部裂开。没有术后感染病例。结论:该过程快速有效。与使用肌肉,肌皮瓣或大网膜瓣的技术相比,该手术的侵略性较小,并保持了组织区域的完整性。作者认为,该技术应作为首选,将皮瓣留给更复杂的复发病例。

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