Analysis of Immediate versus Delayed Sternal Reconstruction with Pectoralis Major Advancement Versus Turnover Muscle Flaps.


Journal

Journal of reconstructive microsurgery
ISSN: 1098-8947
Titre abrégé: J Reconstr Microsurg
Pays: United States
ID NLM: 8502670

Informations de publication

Date de publication:
Oct 2019
Historique:
pubmed: 11 5 2019
medline: 25 2 2020
entrez: 11 5 2019
Statut: ppublish

Résumé

 The pectoralis major muscle flap is a versatile reconstructive option for deep sternal wound infections (DSWI). The timing and surgical technique of bilateral pectoralis major muscle advancement flaps versus unilateral pectoralis major muscle turnover and unilateral pectoralis major muscle advancement flap on patient outcomes remain to be elucidated. The purpose of this investigation was to compare timing, immediate versus delayed reconstruction, and the surgical technique in patients with deep sternal wounds infections on patient outcomes.  A retrospective review of patients who underwent sternal reconstruction with pectoralis major muscle was conducted. Patients diagnosed with DSWI after undergoing cardiac surgery were included for analysis. Patients were divided by flap timing and flap type for analyses. Bivariate tests were performed to compare patient clinical characteristics. Outcomes of interest were rates of postoperative complications, same admission mortality, reoperation, readmission, operating room time, and length of stay.  A total of 88 patients were included for analyses (  Patients who underwent pectoralis major muscle advancement flaps had lower incidence of tissue necrosis. Furthermore, the timing of immediate sternal reconstruction was associated with a decreased hospital length of stay.

Sections du résumé

BACKGROUND BACKGROUND
 The pectoralis major muscle flap is a versatile reconstructive option for deep sternal wound infections (DSWI). The timing and surgical technique of bilateral pectoralis major muscle advancement flaps versus unilateral pectoralis major muscle turnover and unilateral pectoralis major muscle advancement flap on patient outcomes remain to be elucidated. The purpose of this investigation was to compare timing, immediate versus delayed reconstruction, and the surgical technique in patients with deep sternal wounds infections on patient outcomes.
METHODS METHODS
 A retrospective review of patients who underwent sternal reconstruction with pectoralis major muscle was conducted. Patients diagnosed with DSWI after undergoing cardiac surgery were included for analysis. Patients were divided by flap timing and flap type for analyses. Bivariate tests were performed to compare patient clinical characteristics. Outcomes of interest were rates of postoperative complications, same admission mortality, reoperation, readmission, operating room time, and length of stay.
RESULTS RESULTS
 A total of 88 patients were included for analyses (
CONCLUSION CONCLUSIONS
 Patients who underwent pectoralis major muscle advancement flaps had lower incidence of tissue necrosis. Furthermore, the timing of immediate sternal reconstruction was associated with a decreased hospital length of stay.

Identifiants

pubmed: 31075802
doi: 10.1055/s-0039-1688760
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

602-608

Informations de copyright

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Déclaration de conflit d'intérêts

Dr. E.S.G. is the founder of SigmaSurgical, llc, and a consultant for Stryker Corp.

Auteurs

George N Kamel (GN)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Joshua Jacobson (J)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Amanda M Rizzo (AM)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Corin Kinkhabwala (C)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Frank Lalezar (F)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Lawrence Draper (L)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Oren M Tepper (OM)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Evan S Garfein (ES)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

Katie E Weichman (KE)

Division of Plastic Surgery, Montefiore Medical Center, Bronx, New York, United States.

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Classifications MeSH