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

• Published in: Einstein (São Paulo, Brazil) Brazil), 2012-10, Vol.10 (4), p.449-454
• Main Authors: Anger, Jaime, Farsky, Pedro Silvio, Almeida, Antonio Flavio Sanches, Arnoni, Renato Tambellini, Dantas, Daniel Chagas
• Format: Article
• Language: English
• Subjects: Aged; fascia; Fasciotomy; Female; Humans; Inventions; Male; mediastinitis; MEDICINE, GENERAL & INTERNAL; Middle Aged; Pectoralis Muscles - transplantation; sternotomy; Sternotomy - adverse effects; Sternum - surgery; Surgical Flaps; Surgical Wound Dehiscence - surgery; surgical wound infection; Surgical Wound Infection - surgery; Treatment Outcome
• ISSN: 1679-4508; 2317-6385; 2317-6385; 1679-4508
• DOI: 10.1590/S1679-45082012000400010

To describe a new surgical technique for the treatment dehiscence after median thoracotomy transsternal using fasciocutaneous flap composed of the pectoralis major fascia. 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. All patients had favorable outcome following 90 days, not having any partial or total dehiscence. There were no cases of postoperative infection. 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.