Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Brazilian Journal of Cardiovascular Surgery (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378 |
Resumo: | Abstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. Results: During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes. |
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Brazilian Journal of Cardiovascular Surgery (Online) |
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|
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Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound DehiscenceSurgical FlapsSurgical Wound DehiscenceSternumMediastinal Thoracic WallAbstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. Results: During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes.Sociedade Brasileira de Cirurgia Cardiovascular2017-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378Brazilian Journal of Cardiovascular Surgery v.32 n.5 2017reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.21470/1678-9741-2017-0038info:eu-repo/semantics/openAccessHorácio,Grazielle de SouzaColtro,Pedro SolerAlbacete Neto,AntonioAlmeida,Juliano BaronSilva,Vinícius Zolezi daAlmeida,Ivan de RezendeRodrigues,Alfredo JoséFarina Junior,Jayme Adrianoeng2017-11-22T00:00:00Zoai:scielo:S0102-76382017000500378Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2017-11-22T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false |
dc.title.none.fl_str_mv |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
spellingShingle |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence Horácio,Grazielle de Souza Surgical Flaps Surgical Wound Dehiscence Sternum Mediastinal Thoracic Wall |
title_short |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_full |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_fullStr |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_full_unstemmed |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
title_sort |
Application of Unilateral Pectoralis Major Muscle Flap in the Treatment of Sternal Wound Dehiscence |
author |
Horácio,Grazielle de Souza |
author_facet |
Horácio,Grazielle de Souza Coltro,Pedro Soler Albacete Neto,Antonio Almeida,Juliano Baron Silva,Vinícius Zolezi da Almeida,Ivan de Rezende Rodrigues,Alfredo José Farina Junior,Jayme Adriano |
author_role |
author |
author2 |
Coltro,Pedro Soler Albacete Neto,Antonio Almeida,Juliano Baron Silva,Vinícius Zolezi da Almeida,Ivan de Rezende Rodrigues,Alfredo José Farina Junior,Jayme Adriano |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Horácio,Grazielle de Souza Coltro,Pedro Soler Albacete Neto,Antonio Almeida,Juliano Baron Silva,Vinícius Zolezi da Almeida,Ivan de Rezende Rodrigues,Alfredo José Farina Junior,Jayme Adriano |
dc.subject.por.fl_str_mv |
Surgical Flaps Surgical Wound Dehiscence Sternum Mediastinal Thoracic Wall |
topic |
Surgical Flaps Surgical Wound Dehiscence Sternum Mediastinal Thoracic Wall |
description |
Abstract Objective: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. Methods: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained. Results: During this period, 11 patients had their dehiscence of sternotomy treated by unilateral pectoralis major muscle flap. The patients had a mean age of 54.7 years, the mean hospital stay after flap reconstruction was 17.9 days (from 7 to 52 days). In two patients, it was necessary to harvest a flap from the rectus abdominis fascia, in association with the pectoralis major muscle flap, to facilitate the closure of the distal wound. In the postoperative period, seroma discharge from the surgical wound was observed in six patients, five reported intense pain (temporary), three had partial cutaneous dehiscence, and two presented granuloma of the incision. Conclusion: The complex wound from sternotomy dehiscences presents itself as a challenge to surgical teams. Treatment should include debridement of necrotic tissue and preferably coverage with well-vascularized tissue. We propose that the unilateral pectoralis major muscle flap is an interesting and low morbidity option for the reconstruction of sternal wound dehiscences, with proper sternum stability and satisfactory functional and aesthetic outcomes. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-10-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382017000500378 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.21470/1678-9741-2017-0038 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
publisher.none.fl_str_mv |
Sociedade Brasileira de Cirurgia Cardiovascular |
dc.source.none.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery v.32 n.5 2017 reponame:Brazilian Journal of Cardiovascular Surgery (Online) instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV |
instname_str |
Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
instacron_str |
SBCCV |
institution |
SBCCV |
reponame_str |
Brazilian Journal of Cardiovascular Surgery (Online) |
collection |
Brazilian Journal of Cardiovascular Surgery (Online) |
repository.name.fl_str_mv |
Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) |
repository.mail.fl_str_mv |
||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br |
_version_ |
1752126599826767872 |