Complete Sternectomy for Chronic Osteomyelitis with Reconstruction Using a Rectus Abdominis Myocutaneous Island Flap

Neale, Henry W.; Kreilein, Joel G.; Schreiber, J T; Gregory, Richard O.

doi:10.1097/00000637-198104000-00010

Cited by 34 publications

(13 citation statements)

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“…(18,19,21) In the present study, the mean length of postoperative hospital stay decreased from 40.1 days (conservative treatment) to 27.4 days (aggressive treatment), which resulted in early rehabilitation and lower hospital costs. This datum is comparable to those reported in other studies.…”

Section: Discussionmentioning

confidence: 45%

“…(9,18,21) The transposition of the rectus abdominis muscle requires, preferably, the existence of blood flow in the superior epigastric vessels, that is, in the ipsilateral internal thoracic artery. (9,18,19,21) In our study, we preferred to cover the lower mediastinum, when necessary, with the omentum. The use of a dorsal muscle flap seems to be indicated only in cases in which it is impossible to use the pectoral muscles, the rectus abdominis muscles, or the omentum.…”

Section: Discussionmentioning

confidence: 99%

“…(9,(17)(18)(19)(20)(21) Early aggressive treatment has been recommended by various authors. Early diagnosis is considered to play a key role in therapeutic success in this severe infectious complication following sternotomy.…”

Section: Introductionmentioning

confidence: 99%

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Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

et al. 2008

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OBJETIVO: Avaliar o impacto do tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia sobre a mortalidade, comparando-o ao do tratamento conservador. MÉTODOS: Foram coletados dados pré-, trans- e pós-operatórios. O grupo A (n = 44) incluiu pacientes submetidos ao tratamento conservador-desbridamento associado a ressutura e/ou a irrigação contínua com solução de polivinilpirrolidona-iodo, ou ainda a cicatrização por segunda intenção (dados retrospectivos). O grupo B (n = 9) incluiu pacientes nos quais não houve resolução da infecção com o tratamento conservador e que, por isso, foram submetidos ao tratamento agressivo (fase intermediária). O grupo C (n = 28) incluiu pacientes submetidos primariamente ao tratamento agressivo (dados prospectivos). RESULTADOS: Identificou-se menor tempo de internação pós-operatória nos pacientes submetidos ao tratamento agressivo (p < 0,046). Houve 7 óbitos no grupo A, 1 no grupo B e 2 no grupo C. Entretanto, o nível de significância clássico de α = 0,05 não foi atingido. CONCLUSÕES: O tratamento agressivo mostrou-se também adequado para aquelas infecções em que o tratamento conservador não foi resolutivo. Esses achados demonstram que o tratamento proposto tem excelentes resultados.

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Section: Discussionmentioning

confidence: 45%

Section: Discussionmentioning

confidence: 99%

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Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

et al. 2008

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“…11 Pectoralis major, latissimus dorsi, rectus abdominis and omentum flaps are frequently used for reconstruction of sternal wounds. [12][13][14][15] The omentum flap might be used for anterior chest wall and sternal defects when local muscle flaps are not available. Free flaps are an option when regional flaps fail or are unavailable.…”

Section: Discussionmentioning

confidence: 99%

Thoracoacromial artery perforator flap based on the clavicular branch: A new option in regional reconstruction

et al. 2014

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Aim Thoarcoacromial artery‐based perforator flaps are rarely used in clinical practice, especially for the reconstruction of head, neck and axillary regions. In the present study, we present a case with an anterior chest wall soft tissue defect that was reconstructed using a thoarcoacromial artery‐based perforator flap based on the clavicular branch. Patients and Methods A 65‐year‐old male patient presented with an anterior chest wall defect secondary to tumour resection, which was reconstructed using a thoarcoacromial artery‐based perforator flap. Results The patient healed successfully without any early or late complications. To date, he is still followed up by plastic surgery and oncology departments. Conclusion Although there may be variable consistencies, the thoracoacromial artery perforator flap could be a good alternative to pectoralis major flap for upper chest wall, axilla and neck reconstructions.

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“…Transfer of the rectus abdominis muscle (RAM) was first clinically described by Mathes to reconstruct an abdominal wall defect and quickly evolved into a technique for reconstruction of infected sternotomy wounds. 24 It has since become a popular option for breast reconstruction, Figure 4 A 67-year-old man with a history of diabetes, smoking, and previous CABG. The patient had sternal dehiscence and drainage and was managed with dressing changes at home.…”

Section: Rectus Abdominis Flapmentioning

confidence: 99%

Workhorse Flaps in Chest Wall Reconstruction: The Pectoralis Major, Latissimus Dorsi, and Rectus Abdominis Flaps

Bakri¹,

Mardini²,

Evans³

et al. 2011

Seminars in Plastic Surgery

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Large and life-threatening thoracic cage defects can result from the treatment of traumatic injuries, tumors, infection, congenital anomalies, and radiation injury and require prompt reconstruction to restore respiratory function and soft tissue closure. Important factors for consideration are coverage with healthy tissue to heal a wound, the potential alteration in respiratory mechanics created by large extirpations or nonhealing thoracic wounds, and the need for immediate coverage for vital structures. The choice of technique depends on the size and extent of the defect, its location, and donor site availability with consideration to previous thoracic or abdominal operations. The focus of this article is specifically to describe the use of the pectoralis major, latissimus dorsi, and rectus abdominis muscle flaps for reconstruction of thoracic defects, as these are the workhorse flaps commonly used for chest wall reconstruction.

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Complete Sternectomy for Chronic Osteomyelitis with Reconstruction Using a Rectus Abdominis Myocutaneous Island Flap

Cited by 34 publications

References 0 publications

Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

Thoracoacromial artery perforator flap based on the clavicular branch: A new option in regional reconstruction

Workhorse Flaps in Chest Wall Reconstruction: The Pectoralis Major, Latissimus Dorsi, and Rectus Abdominis Flaps

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