Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence
Abstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternot...
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Sociedade Brasileira de Cirurgia Cardiovascular
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doaj-325f23fbf4314822920f42672d3c37a62020-11-24T23:51:58ZengSociedade Brasileira de Cirurgia CardiovascularBrazilian Journal of Cardiovascular Surgery1678-974132537838210.21470/1678-9741-2017-0038S0102-76382017000500378Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound DehiscenceGrazielle de Souza HorácioPedro Soler ColtroAntonio Albacete NetoJuliano Baron AlmeidaVinícius Zolezi da SilvaIvan de Rezende AlmeidaAlfredo José RodriguesJayme Adriano Farina JuniorAbstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. Results: During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378&lng=en&tlng=enSurgical FlapsSurgical Wound DehiscenceSternumMediastinal Thoracic Wall |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Grazielle de Souza Horácio Pedro Soler Coltro Antonio Albacete Neto Juliano Baron Almeida Vinícius Zolezi da Silva Ivan de Rezende Almeida Alfredo José Rodrigues Jayme Adriano Farina Junior |
spellingShingle |
Grazielle de Souza Horácio Pedro Soler Coltro Antonio Albacete Neto Juliano Baron Almeida Vinícius Zolezi da Silva Ivan de Rezende Almeida Alfredo José Rodrigues Jayme Adriano Farina Junior Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence Brazilian Journal of Cardiovascular Surgery Surgical Flaps Surgical Wound Dehiscence Sternum Mediastinal Thoracic Wall |
author_facet |
Grazielle de Souza Horácio Pedro Soler Coltro Antonio Albacete Neto Juliano Baron Almeida Vinícius Zolezi da Silva Ivan de Rezende Almeida Alfredo José Rodrigues Jayme Adriano Farina Junior |
author_sort |
Grazielle de Souza Horácio |
title |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_short |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_full |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_fullStr |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_full_unstemmed |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_sort |
application of unilateral pectoralis major muscle flap in the treatment of sternal wound dehiscence |
publisher |
Sociedade Brasileira de Cirurgia Cardiovascular |
series |
Brazilian Journal of Cardiovascular Surgery |
issn |
1678-9741 |
description |
Abstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. Results: During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes. |
topic |
Surgical Flaps Surgical Wound Dehiscence Sternum Mediastinal Thoracic Wall |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378&lng=en&tlng=en |
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