Free latissimus dorsi flap for chest wall repair after complete resection of infected sternum

Détails

ID Serval
serval:BIB_F86CC4153F98
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Free latissimus dorsi flap for chest wall repair after complete resection of infected sternum
Périodique
Annals of Thoracic Surgery
Auteur(s)
Banic  A., Ris  H. B., Erni  D., Striffeler  H.
ISSN
0003-4975 (Print)
Statut éditorial
Publié
Date de publication
10/1995
Volume
60
Numéro
4
Pages
1028-1032
Notes
Journal Article --- Old url value: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=7574942 --- Old month value: Oct
Résumé
BACKGROUND. Radical debridement, followed by muscle flap cover, has significantly reduced morbidity and mortality of infected sternotomy wounds. The pectoralis major, rectus abdominis, and greater omentum flaps are most commonly used, whereas the latissimus dorsi muscle is rarely employed. METHODS. In 7 patients with persistent infection and necrosis of the sternum, radical and extensive debridement including the sternum, costochondral arches, manubrium and sternoclavicular joints was performed. A free latissimus dorsi flap was used for soft tissue reconstruction without additional stabilization of the chest wall. RESULTS. All flaps survived without revision of the anastomosis. In the follow-up period (22 months to 5 years) no recurrent infection was observed. Three patients died during the study period (3 to 24 months after operation) due to causes not related to sternum operation. No additional weakness, pain, or restricted movements of the shoulders due to missing sternum was observed. CONCLUSIONS. Our findings suggest that the use of free latissimus dorsi flap after complete sternectomy for infection has several advantages: it provides abundant tissue to allow radical and extensive debridement, obliterates completely the dead space, and helps to control infection. Even without additional chest wall reconstruction it gives enough stability to allow pain-free normal daily activities.
Mots-clé
Aged *Debridement Humans Middle Aged Necrosis Osteomyelitis/*surgery Sternum/pathology/*surgery Surgical Flaps/*methods Surgical Wound Infection/*surgery
Pubmed
Web of science
Création de la notice
29/01/2008 14:00
Dernière modification de la notice
03/03/2018 22:52
Données d'usage