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Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection.

Publication ,  Journal Article
Spartalis, E; Markakis, C; Moris, D; Lachanas, E; Agathos, EA; Karakatsani, A; Karagkiouzis, G; Athanasiou, A; Dimitroulis, D; Tomos, P
Published in: Surgery today
April 2016

Post-sternotomy deep sternal wound infection (DSWI) is a severe complication of cardiac surgery. The introduction of omental and muscle flaps has resulted in a significant decrease in morbidity and mortality. In this article, we present the findings for a series of 55 consecutive patients with DSWI treated using an alternative bi-pectoral musculofascial flap technique.The patients were stratified into two groups (one-or two-stage intervention). Patients with septic wounds initially underwent debridement and wound treatment, while vacuum therapy was used in a subset of the subjects. All patients were treated with wound debridement and bi-pectoral advancement flap reconstruction.30-day mortality was 5.4%. Most patients (72%) were treated in two stages, while vacuum therapy was used in 20% of the patients. The mean number of hospitalization days was 8 and 12 for the one- and the two-stage groups, respectively. Reconstruction was successful in all but three patients, each of whom developed recurrent infection. No major morbidity was reported at a mean follow-up of 82 months with excellent functional and aesthetic outcomes.Pectoralis-major muscle flaps remain relevant in the modern management of post-sternotomy mediastinitis. The addition of an omental flap should be considered in cases in which the lower sternum is involved. Prompt diagnosis and a meticulous surgical technique ensure favorable results for the majority of patients.

Duke Scholars

Published In

Surgery today

DOI

EISSN

1436-2813

ISSN

0941-1291

Publication Date

April 2016

Volume

46

Issue

4

Start / End Page

460 / 465

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Surgical Flaps
  • Surgery
  • Sternotomy
  • Severity of Illness Index
  • Plastic Surgery Procedures
  • Pectoralis Muscles
  • Mediastinitis
  • Male
 

Citation

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Spartalis, E., Markakis, C., Moris, D., Lachanas, E., Agathos, E. A., Karakatsani, A., … Tomos, P. (2016). Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection. Surgery Today, 46(4), 460–465. https://doi.org/10.1007/s00595-015-1192-5
Spartalis, Eleftherios, Charalampos Markakis, Demetrios Moris, Elias Lachanas, E Andreas Agathos, Anna Karakatsani, Grigorios Karagkiouzis, Antonios Athanasiou, Dimitrios Dimitroulis, and Periklis Tomos. “Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection.Surgery Today 46, no. 4 (April 2016): 460–65. https://doi.org/10.1007/s00595-015-1192-5.
Spartalis E, Markakis C, Moris D, Lachanas E, Agathos EA, Karakatsani A, et al. Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection. Surgery today. 2016 Apr;46(4):460–5.
Spartalis, Eleftherios, et al. “Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection.Surgery Today, vol. 46, no. 4, Apr. 2016, pp. 460–65. Epmc, doi:10.1007/s00595-015-1192-5.
Spartalis E, Markakis C, Moris D, Lachanas E, Agathos EA, Karakatsani A, Karagkiouzis G, Athanasiou A, Dimitroulis D, Tomos P. Results of the modified bi-pectoral muscle flap procedure for post-sternotomy deep wound infection. Surgery today. 2016 Apr;46(4):460–465.
Journal cover image

Published In

Surgery today

DOI

EISSN

1436-2813

ISSN

0941-1291

Publication Date

April 2016

Volume

46

Issue

4

Start / End Page

460 / 465

Related Subject Headings

  • Treatment Outcome
  • Surgical Wound Infection
  • Surgical Flaps
  • Surgery
  • Sternotomy
  • Severity of Illness Index
  • Plastic Surgery Procedures
  • Pectoralis Muscles
  • Mediastinitis
  • Male