R. Wettstein, MD, D. Erni, MD, P. Berdat, MD, D. Rothenfluh, A

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Presentation transcript:

Radical sternectomy and primary musculocutaneous flap reconstruction to control sternal osteitis R. Wettstein, MD, D. Erni, MD, P. Berdat, MD, D. Rothenfluh, A. Banic, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 123, Issue 6, Pages 1185-1190 (June 2002) DOI: 10.1067/mtc.2002.121304 Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 A, Large defect of thoracic wall and soft tissues results after radical resection of entire infected sternum, including affected overlying muscle and skin (B). C, Thoracic wall defect is reconstructed with muscle part of free latissimus dorsi musculocutaneous flap. D, Skin paddle provides sufficient tissue to avoid tension as well as dead space between reconstructed thoracic wall and skin. The Journal of Thoracic and Cardiovascular Surgery 2002 123, 1185-1190DOI: (10.1067/mtc.2002.121304) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Local complications necessitating surgical revision after radical sternectomy and chest wall repair with vertical rectus abdominis musculocutaneous flap (VRAM, n = 13), pedicled latissimus dorsi musculocutaneous flap (pLDM, n = 15) and free latissimus dorsi musculocutaneous flap (fLDM, n = 12). Complications included epigastric hernia (down and right pointing narrow diagonally filled bars), seroma or hematoma of donor site (up and right pointing wide diagonally filled bars), seroma or hematoma of flap (black bars), wound dehiscence at donor site (dotted bars), wound dehiscence at flap (up and right pointing narrow diagonally filled bars), and partial flap loss (down and right pointing wide diagonally filled bars). The Journal of Thoracic and Cardiovascular Surgery 2002 123, 1185-1190DOI: (10.1067/mtc.2002.121304) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Long-term follow-up after radical sternectomy and chest wall repair with vertical rectus abdominis musculocutaneous flap (VRAM, n = 11), pedicled latissimus dorsi musculocutaneous flap (pLDM, n = 14) and free latissimus dorsi musculocutaneous flap (fLDM, n = 8). Negative reports included rubbing (up and right pointing diagonally filled bars), pain medication requirement (dotted bars), minor pain at activity (black bars), and discomfort at rest (down and right pointing diagonally filled bars). The Journal of Thoracic and Cardiovascular Surgery 2002 123, 1185-1190DOI: (10.1067/mtc.2002.121304) Copyright © 2002 American Association for Thoracic Surgery Terms and Conditions