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

• Main Authors: Jaime Anger, Pedro Silvio Farsky, Antonio Flavio Sanches Almeida, Renato Tambellini Arnoni, Daniel Chagas Dantas
• Format: Article
• Language: English
• Published: Instituto Israelita de Ensino e Pesquisa Albert Einstein
• Series: Einstein (São Paulo)
• Subjects: sternotomy; surgical wound infection; fascia; surgical flaps; mediastinitis
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082012000400010&lng=en&tlng=en
• ISSN: 1679-4508; 2317-6385

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