1990
DOI: 10.1055/s-2007-1014016
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Abstract: Median sternotomy is complicated by deep infection in 1-5% of cases. Internal mammary artery grafting (especially bilateral) may increase incidence and severity. Mediastinitis accompanied by sternal necrosis has a reported mortality up to 30%. The defect resulting from removal of dead bone requires reconstruction and skin cover. Twelve patients are presented in whom this defect was abolished by omental transposition. There were no deaths. Seven had chronically infected wounds (median time to operation 100 days… Show more

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Cited by 13 publications
(7 citation statements)
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References 11 publications
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“…For severe sternal infection, early radical debridement, tissue transposition, and direct closure possibly reduces morbidity and hospital stay. 6 The size and characteristics of the resulting defect, as well as the nature of the patient's initial operation, should dictate which flaps are used to stabilize the thorax and close the dead space. The upper two thirds of the sternal defect can be covered well with one or both pectoralis major muscles based upon the thoracoacromial arterial axis.…”
Section: Treatmentmentioning
confidence: 99%
“…For severe sternal infection, early radical debridement, tissue transposition, and direct closure possibly reduces morbidity and hospital stay. 6 The size and characteristics of the resulting defect, as well as the nature of the patient's initial operation, should dictate which flaps are used to stabilize the thorax and close the dead space. The upper two thirds of the sternal defect can be covered well with one or both pectoralis major muscles based upon the thoracoacromial arterial axis.…”
Section: Treatmentmentioning
confidence: 99%
“…Ultimamente, com a colaboração de cirurgiões plásticos, reconstruções têm sido feitas, primárias ou seguindo a drenagem aberta ou ainda após irrigação fechada que falhou, assim como em infecções crônicas. Utilizam-se nestas reconstruções, retalhos musculares (peitoral, reto abdominal) e também o epíploon (30)(31)(32)(33)(34)(35)(36)(37)(38) .…”
unclassified
“…(6,22,23) The comparison of this mortality rate with that found in group C of the present study (close to zero) reveals that this technique, though aggressive, greatly reduces mortality. (21,(24)(25)(26) Regarding risk factors, we did not intend to analyze them statistically as a cause of infection. Rather, we intended to demonstrate that risk factors are homogeneously distributed in the groups studied, so that none of them would significantly alter the number of complications and deaths in the groups studied.…”
Section: Discussionmentioning
confidence: 99%
“…In addition, omentoplasty serves as an exceptional alternative in cases of muscle flap treatment failure. (9,17,24,30) In cases of complete sternal resection, it is important to remove the adjacent costal cartilages if chondritis or signs of necrosis appear. Cartilages constitute one of the principal sites of reinfec-…”
Section: Discussionmentioning
confidence: 99%