Plastic and Reconstructive Surgery, Global Open (Nov 2019)

Sternal Wound Reconstruction Made Simple

  • Adam S. Levy, MD,
  • Jeffrey A. Ascherman, MD

DOI
https://doi.org/10.1097/GOX.0000000000002488
Journal volume & issue
Vol. 7, no. 11
p. e2488

Abstract

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Summary:. Sternal wounds and associated infections represent a complex reconstructive problem in a highly morbid patient population. Through strict adherence to excellent plastic surgical principles, this process can be simplified, allowing safe and effective wound closure. Emphasis is placed on thorough debridement, hardware removal, obtaining adequate tissue cultures, and finally, appropriate flap closure. In most cases, pectoralis major myocutaneous advancement flaps provide excellent coverage while eliminating dead space and providing sternal compression. Secondary flap options, such as the omental flap or rectus abdominis muscle, may occasionally be necessary. This article will provide an overview and simplified approach to sternal wound reconstruction.