Efficacy and safety of pectoralis muscle flap combined rectus abdominis muscle sheath fasciocutaneous flap for reconstruction of sternal infection. Issue 7 (15th March 2022)

• Record Type: Journal Article
• Authors: Yu, Chieh‐Ming; Yu, Chia‐Meng; Yao, Wen‐Teng; Chen, Yu‐Fan; Lee, An‐Li; Liu, Ying‐Chun; Tu, Chih‐Peng; Huang, Wen‐Chen; Tung, Kwang‐Yi; Tsai, Ming‐Feng
• Is Part Of: International wound journal. Volume 19:Issue 7(2022)
• Page Start: 1829
• Page End: 1837
• Publication Date: 2022-03-15
• Subjects: pectoralis myocutaneous flap -- rectus abdominis fasciocutaneous flap -- sternal closure -- sternal reconstruction -- sternal wound infection; Wounds and injuries -- Treatment -- Periodicals; Wounds and injuries -- Periodicals; Wound healing -- Periodicals; 617.1005
• DOI: 10.1111/iwj.13788
• Languages: English
• ISSNs: 1742-4801

Abstract

Abstract: Few studies have assessed the efficacy and safety of reconstruction of sternal infection using a pectoralis muscle flap combined with a rectus abdominis muscle (RAM) sheath fasciocutaneous flap. We report here our experience with this procedure to reconstruct the sternal defect in patients (n = 46) with a deep sternal wound infection (DSWI) after cardiac surgery. After wound reconstruction, the proportion of prolonged mechanical ventilation use and intensive care unit (ICU) stay were 17.4% (n = 8) and 21.7% (n = 10), respectively. The 30‐day all‐cause mortality was 15.2%; recurrence rate was 17.4%; postoperative complications were 15.2%; and median hospital stay was 31 (0‐157) days. Multivariate logistic regression analysis revealed that hypertension (β = 21.32, 95%CI 4.955‐37.68, P = .014), drainage‐tube use (β = 0.944, 95%CI 0.273‐1.614, P = .008), and prolonged intensive care unit stay (β = 53.65, 95%CI 31.353‐75.938, P < .001) were significantly correlated with hospital stay. In conclusion, a procedure including surgical debridement, sternal reconstruction with bilateral PM and RAM sheath flap, long‐term antibiotics, and adequate drainage is a beneficial technique in the reconstruction of deep sternal wound infection after cardiac surgery. Duration of drainage tube use may be as an index for a hospital stay or wound healing.