The laparoscopically harvested omental flap for deep sternal wound infection

Wingerden, Jan J. van; Coret, Matijn E.H.; Nieuwenhoven, Christianne A. van; Totté, E.

doi:10.1016/j.ejcts.2009.06.020

Cited by 35 publications

(27 citation statements)

References 24 publications

(32 reference statements)

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“…32,33 Laparotomically or laparoscopically harvested omental flaps have been used for reconstructive surgery of superficial extra-abdominal structures. For instance, they have been used to treat large scalp defects, 34 sternal wound infections after sternotomy for coronary artery bypass grafting, 35 scrotal reconstruction, 36–38 soft tissue augmentation of breasts 39 and facial contour defects. 40,41 In rats, fragmented omental tissues, with or without cotransplantation with preadipocytes, have been proved potentially useful for soft tissue augmentation.…”

Section: Discussionmentioning

confidence: 99%

Decellularized omentum as novel biologic scaffold for reconstructive surgery and regenerative medicine

et al. 2013

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Homologous tissues, such as adipose tissue, may be an interesting source of acellular scaffolds, maintaining a complex physiological three-dimensional (3D) structure, to be recellularized with autologous cells. The aim of the present work is to evaluate the possibility of obtaining homologous acellular scaffolds from decellularization of the omentum, which is known to have a complex vascular network. Adult rat and human omenta were treated with an adapted decellularization protocol involving mechanical rupture (freeze-thaw cycles), enzymatic digestion (trypsin, lipase, deoxyribonuclease, ribonuclease) and lipid extraction (2-propanol). Histological staining confirmed the effectiveness of decellularization, resulting in cell-free scaffolds with no residual cells in the matrix. The complex 3D networks of collagen (azan-Mallory), elastic fibers (Van Gieson), reticular fibers and glycosaminoglycans (PAS) were maintained, whereas Oil Red and Sudan stains showed the loss of lipids in the decellularized tissue. The vascular structures in the tissue were still visible, with preservation of collagen and elastic wall components and loss of endothelial (anti-CD31 and -CD34 immunohistochemistry) and smooth muscle (anti-alpha smooth muscle actin) cells. Fat-rich and well vascularized omental tissue may be decellularized to obtain complex 3D scaffolds preserving tissue architecture potentially suitable for recellularization. Further analyses are necessary to verify the possibility of recolonization of the scaffold by adipose-derived stem cells in vitro and then in vivo after re implantation, as already known for homologus implants in regenerative processes.

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Section: Discussionmentioning

confidence: 99%

Decellularized omentum as novel biologic scaffold for reconstructive surgery and regenerative medicine

et al. 2013

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“…Therapeutic options for the treatment of mediastinitis include debridement with early or late closure of the chest, debridement and closure with continuous irrigation using 0.9% saline solution, partial or total sternectomy associated to reconstruction of muscle flaps or caul, in addition to adjuvant therapies, such as the system of vacuum-assisted therapy and hyperbaric oxygenation [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Preoperative risk factors for mediastinitis after cardiac surgery: analysis of 2768 patients

Tiveron¹,

Fiorelli²,

Mota³

et al. 2012

Rev Bras Cir Cardiovasc

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“…52 The flap is usually raised on the larger right gastroepiploic artery and can be delivered into the sternal defect through the anterior tendinous portion of the diaphragm or through the wound and over the costal margin via a subcutaneous tunnel. 52 The flap is usually raised on the larger right gastroepiploic artery and can be delivered into the sternal defect through the anterior tendinous portion of the diaphragm or through the wound and over the costal margin via a subcutaneous tunnel.…”

Section: Omentummentioning

confidence: 99%

Chest wall reconstruction

Kanani

Elliott

Withey

et al. 2015

Plastic and Reconstructive Surgery

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The laparoscopically harvested omental flap for deep sternal wound infection

Abstract: The laparoscopically harvested omental flap can contribute to a successful outcome following deep sternal wound infection and deserves serious consideration in type IV mediastinitis in particular, regardless of the co-morbidity or previous abdominal surgery.

Cited by 35 publications

References 24 publications

Decellularized omentum as novel biologic scaffold for reconstructive surgery and regenerative medicine

Decellularized omentum as novel biologic scaffold for reconstructive surgery and regenerative medicine

Preoperative risk factors for mediastinitis after cardiac surgery: analysis of 2768 patients

Chest wall reconstruction

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