Document Detail

Two-stage reconstruction of infected deep median sternotomy wound with an intercostal pedicled oblique rectus abdominis musculocutaneous flap after coronary artery bypass grafting.
MedLine Citation:
PMID:  14520073     Owner:  NLM     Status:  MEDLINE    
Median sternotomy wounds infected after coronary artery bypass grafting with bilateral internal mammary arteries are generally poor in condition, cannot be debrided adequately, and are limited in flap selection for reconstruction. The authors treated 2 patients with two-stage reconstruction using a modified superior-based rectus abdominis musculocutaneous flap. First, simple debridement was performed with the goal of preserving the internal mammary artery grafts. Then, delayed reconstruction with the oblique rectus abdominis musculocutaneous flap supplied by the superior epigastric and seventh intercostal vessels was performed. Despite ligature of the bilateral internal mammary arteries at their full length, the large oblique skin paddle designed along the angiosome as far as the midaxillary line survived almost completely in both patients, resulting in cessation of pus discharge. The circulation to the superior epigastric and intercostal vessels might be reinforced because of the delay phenomenon. Two-stage reconstruction with a superior pedicled oblique rectus abdominis musculocutaneous flap presents a successful resolution of infected median sternotomy wounds after coronary artery bypass grafting with sacrifice of bilateral internal mammary arteries.
Yasushi Mochizuki; Mutsumi Okazaki; Reiko Kurashina; Mayuko Kano
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Annals of plastic surgery     Volume:  51     ISSN:  0148-7043     ISO Abbreviation:  Ann Plast Surg     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-01     Completed Date:  2004-02-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7805336     Medline TA:  Ann Plast Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  423-8     Citation Subset:  IM    
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Japan.
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MeSH Terms
Aged, 80 and over
Internal Mammary-Coronary Artery Anastomosis*
Reconstructive Surgical Procedures
Sternum / surgery
Surgical Wound Infection / surgery*

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