Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Pectoralis Major-Rectus Abdominis Bipedicle Muscle Flap in Treatment of Postoperative Mediastinitis

개흉술 후 발생한 종격동염의 대흉근-복직근 양경근피판을 이용한 치료

  • Kim, Bom Jin (Institution for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Lee, Won Jai (Institution for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine) ;
  • Tark, Kwan Chul (Institution for Human Tissue Restoration, Department of Plastic & Reconstructive Surgery, Yonsei University College of Medicine)
  • 김범진 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 이원재 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실) ;
  • 탁관철 (연세대학교 의과대학 인체조직복원연구소, 성형외과학교실)
  • Received : 2005.04.06
  • Published : 2005.07.10
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Abstract

Although the incidence of mediastinal wound infection in patient undergoing median sternotomy for cardiovascular surgery is relatively low(less than 1%), it is not only a devastating and potentially life-threatening complication but also associated morbidity, mortality and cost are unacceptably high. During the past few decades various methods had been applied for the treatment of postoperative mediastinitis. Currently, chest wall reconstruction by using muscle flaps-especially pectoralis major muscle and rectus abdominis muscle are commonly selected for the reconstruction after wide debridement has become widely accepted. We performed bilateral pectoralis major-rectus abdominis muscles in-continuity bipedicle flap to overcome the limit of each flap for reconstruction of sternal defects in 17 patients. We analyzed the results of the surgery. Recurrent infection developed in 17.6% of cases and abdominal herniation was observed in one patient. There was no postoperative hematoma or death. We conclude that this flap is very valuable in reconstruction of the anterior chest wall defect caused by post-sternotomy infection because it provides sufficient volume to fill the entire mediastinum, and the complication rate compares favorably to that of other methods.

Keywords

Acknowledgement

Supported by : 연세대학교

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