Full Thickness Flap of the Greater Pectoral Muscle for Poststernotomy Mediastinitis

Abstract

Poststernotomy mediastinitis is the most severe and dangerous complication in cardiac surgery. Treatment of such patients still poses great difficulties for the surgeon dealing with this problem. At the reconstructive stage, they consist in the lack of criteria for choosing a method of plastic surgery and standardized surgical technologies. The use of autologous tissues is generally performed: greater omentum and muscle flaps. The article presents the experience of treating a patient with poststernotomy mediastinitis. The surgery was two-staged. The effectiveness of using vacuum-assisted dressings has been demonstrated. Performing final debridement and wound preparation followed by repair of the defect with a full-thickness flap of the pectoralis major muscle on the perforating branch of the internal thoracic artery led to the patient’s recovery.

Keywords

• chest wall defect
• poststernotomy mediastinitis
• sternal osteomyelitis
• muscle flap
• perforating branch of the internal thoracic artery