Omental Transposition Flap and Pectoralis Major Muscle Flap for Reconstruction of Wide Sternal Defect.

Seo, Dong Kook; Eun, Seok Chan; Oh, Suk Joon

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2002;29(3):225-229.
Published online May 1, 2002.

Omental Transposition Flap and Pectoralis Major Muscle Flap for Reconstruction of Wide Sternal Defect.

Dong Kook Seo, Seok Chan Eun, Suk Joon Oh

Department of Plastic and Reconstructive Surgery, School of Medicine, Hallym University, Seoul, Korea. sjoh@hallym.or.kr

Abstract

Infected median sternotomy wounds represents one of major complication of cardiothoracic surgery. Although the incidence is less than 1%, its associated morbidity, mortality, and "cost" remain unacceptably high. For the treatment of this recalcitrant wound infections, most patient underwent radical debridement with sternectomy and reconstructed by muscle flaps. The most common combination of flaps being the omentum and bilateral pectoralis major musculocutaneous flaps. In our case, 2 patients who had extensive mediastinal infection at sternotomy wound underwent omental transposition flap pedicled on the right gastroepiploic artery and pectoralis major muscle flap. Omentum has rich lymphatics and high vascularity enough to revascularize the ischemic tissues. Using the greater omentum for infected median sternotomy wound combined with other muscle flap is an useful method for reconstruction of large defects invading lower 1/3 of sternum or retrosternal dead space.

Keywords: Infected median sternotomy wounds; Omental transposition flap