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. 1989;16(1):11–14.

Management of the Complicated Sternotomy Incision

Results of Omentopexy with Primary Skin Graft

Arthur A Hellman 1, David E Lammermeier 1, Denton A Cooley 1
PMCID: PMC324836  PMID: 15227230

Abstract

Non-healing mid-sternotomy wounds are a persistently difficult problem. The numerous methods that have been employed to manage these wounds are costly in terms of patient discomfort and length of hospital stay. We present a method to manage a complicated sternotomy that uses an omental flap with an immediate, split-thickness skin graft. This technique promotes rapid healing and minimizes length of hospital stay. (Texas Heart Institute Journal 1989;16:11-14)

Keywords: Sternum

Keywords: omentum

Keywords: surgical flap

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cohen M., Silverman N. A., Goldfaden D. M., Levitsky S. Reconstruction of infected median sternotomy wounds. Arch Surg. 1987 Mar;122(3):323–327. doi: 10.1001/archsurg.1987.01400150077015. [DOI] [PubMed] [Google Scholar]
  2. Culliford A. T., Cunningham J. N., Jr, Zeff R. H., Isom O. W., Teiko P., Spencer F. C. Sternal and costochondral infections following open-heart surgery. A review of 2,594 cases. J Thorac Cardiovasc Surg. 1976 Nov;72(5):714–726. [PubMed] [Google Scholar]
  3. Edwards M. S., Baker C. J. Median sternotomy wound infections in children. Pediatr Infect Dis. 1983 Mar-Apr;2(2):105–109. doi: 10.1097/00006454-198303000-00007. [DOI] [PubMed] [Google Scholar]
  4. Ford T. D. Rectus abdominis myocutaneous flap used to close a median sternotomy chest defect. A case report. S Afr Med J. 1985 Jul 20;68(2):115–116. [PubMed] [Google Scholar]
  5. Grossi E. A., Culliford A. T., Krieger K. H., Kloth D., Press R., Baumann F. G., Spencer F. C. A survey of 77 major infectious complications of median sternotomy: a review of 7,949 consecutive operative procedures. Ann Thorac Surg. 1985 Sep;40(3):214–223. doi: 10.1016/s0003-4975(10)60030-6. [DOI] [PubMed] [Google Scholar]
  6. Harjula A., Järvinen A. Postoperative median sternotomy dehiscence. Scand J Thorac Cardiovasc Surg. 1983;17(3):277–281. doi: 10.3109/14017438309099365. [DOI] [PubMed] [Google Scholar]
  7. Heath B. J., Bagnato V. J. Poststernotomy mediastinitis treated by omental transfer without postoperative irrigation or drainage. J Thorac Cardiovasc Surg. 1987 Sep;94(3):355–360. [PubMed] [Google Scholar]
  8. Mahoney J. Treatment of the chronically infected median sternotomy wound with muscle flaps. Can J Surg. 1985 Sep;28(5):453–455. [PubMed] [Google Scholar]
  9. Majure J. A., Albin R. E., O'Donnell R. S., Arganese T. J. Reconstruction of the infected median sternotomy wound. Ann Thorac Surg. 1986 Jul;42(1):9–12. doi: 10.1016/s0003-4975(10)61825-5. [DOI] [PubMed] [Google Scholar]
  10. Pairolero P. C., Arnold P. G. Management of recalcitrant median sternotomy wounds. J Thorac Cardiovasc Surg. 1984 Sep;88(3):357–364. [PubMed] [Google Scholar]
  11. Pearl S. N., Dibbell D. G. Reconstruction after median sternotomy infection. Surg Gynecol Obstet. 1984 Jul;159(1):47–52. [PubMed] [Google Scholar]
  12. Pettersson G., Larsson S., Südow G., Holmström H. Use of muscle flaps in the treatment of infected sternotomy. Scand J Thorac Cardiovasc Surg. 1986;20(1):1–4. doi: 10.3109/14017438609105907. [DOI] [PubMed] [Google Scholar]
  13. Pezzella A. T., Fall S. M., Pauling F. W. Management of high-risk sternotomy wounds with retention sutures. Tex Heart Inst J. 1987 Sep;14(3):293–296. [PMC free article] [PubMed] [Google Scholar]
  14. Seguin J. R., Loisance D. Y. Omental transposition for closure of median sternotomy following severe mediastinal and vascular infection. Chest. 1985 Nov;88(5):684–686. doi: 10.1378/chest.88.5.684. [DOI] [PubMed] [Google Scholar]
  15. Shafir R., Weiss J., Herman O., Cohen N., Stern D., Igra Y. Faulty sternotomy and complications after median sternotomy. J Thorac Cardiovasc Surg. 1988 Aug;96(2):310–313. [PubMed] [Google Scholar]
  16. Smith P. S., Roistacher K., Gordon G. M., Merav A. D., Klein R. S. Anaerobic mediastinitis complicating median sternotomy. Am J Med Sci. 1985 Sep;290(3):111–113. doi: 10.1097/00000441-198509000-00006. [DOI] [PubMed] [Google Scholar]
  17. Stevens M. S., de Villiers S. J., Stanton J. J., van Tornout F. A., Steyn F. J. Closure of infected median sternotomy wound with pectoralis major muscle flaps. A report of 3 cases. S Afr Med J. 1988 Feb 20;73(4):247–250. [PubMed] [Google Scholar]
  18. Stiegel R. M., Beasley M. E., Sink J. D., Hester T. R., Guyton R. A., Perrella A. M., Williams W. H. Management of postoperative mediastinitis in infants and children by muscle flap rotation. Ann Thorac Surg. 1988 Jul;46(1):45–46. doi: 10.1016/s0003-4975(10)65850-x. [DOI] [PubMed] [Google Scholar]
  19. Voegele L. D., Metcalf M. M., Prioleau W. H., Jr, Hairston P. Median sternotomy infection. Management and reconstruction. Am Surg. 1985 Nov;51(11):645–647. [PubMed] [Google Scholar]

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