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Reconstruction of s...
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Wyckman, AlexanderLinköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US
(author)
Reconstruction of sternal defects after sternotomy with postoperative osteomyelitis, using a unilateral pectoralis major advancement muscle flap
- Article/chapterEnglish2020
Publisher, publication year, extent ...
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2020-05-20
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Nature Publishing Group,2020
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electronicrdacarrier
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LIBRIS-ID:oai:DiVA.org:liu-165783
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-165783URI
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https://doi.org/10.1038/s41598-020-65398-yDOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Funding agencies: Linkoping University
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BACKGROUND: The pectoralis major flap, which is usually harvested bilaterally, is considered a workhorse flap in the reconstruction of sternal defects. After a median sternotomy for open heart surgery, 1%-3% of patients develop deep infection and dehiscence of the sternal wound, some of which will eventually require reconstructive surgery. Our aim was to describe the clinical feasibility and associated complications of the unilateral pectoralis major advancement flap in the reconstruction of sternal defects.METHODS: A retrospective analysis of all adult patients who were operated on using a unilateral pectoralis major flap for reconstruction of the chest wall at the Linköping University Hospital during 2008-18 was made using data retrieved from medical records.RESULTS: Forty-three patients had reconstructions with unilateral pectoralis major flaps. Three flaps failed completely, and another 10 patients developed complications that required further operation. The factors that were independently associated with loss of the flaps and complications were: older age, male sex, the number of different antibiotics used, and a long duration of treatment with negative wound pressure. Fewer wound revisions before the reconstruction resulted in more complications. The factors that were independently associated with prolonged time to complete healing were emergency reoperation after the initial operation and complications after reconstruction.CONCLUSION: The unilateral pectoralis major advancement flap has proved to be a useful technique in the reconstruction of most sternal defects after sternal wound infection in older patients. There is, however, need for a follow-up study on a larger number of procedures to evaluate the long-term outcome compared with other methods of sternal reconstruction.
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Abdelrahman, Islam,1982-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US,Suez Canal University,Egypt(Swepub:liu)islab76
(author)
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Steinvall, Ingrid,1959-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US(Swepub:liu)ingst90
(author)
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Zdolsek, Johann,1960-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US(Swepub:liu)johzd58
(author)
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Granfeldt, Hans,1960-Linköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Region Östergötland, Thorax-kärlkliniken i Östergötland(Swepub:liu)hangr39
(author)
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Sjöberg, Folke,1956-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US(Swepub:liu)folsj94
(author)
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Nettelblad, Hans,1950-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US(Swepub:liu)hanne68
(author)
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Elmasry, Moustafa,1981-Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Hand- och plastikkirurgiska kliniken US(Swepub:liu)mouel27
(author)
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Linköpings universitetAvdelningen för kirurgi, ortopedi och onkologi
(creator_code:org_t)
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In:Scientific Reports: Nature Publishing Group10:12045-2322
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