Document Detail

A four-muscle-flap for thoracomyoplasty in patients with sacrificed thoracodorsal vessels.
MedLine Citation:
PMID:  20558119     Owner:  NLM     Status:  In-Data-Review    
METHODS: Between 2002 and 2008, we performed the four-muscle-flap on seven patients (mean age 68±7.9 years) with residual empyema space. Three cases were combined with a bronchopleural fistula. All patients received a two-stage procedure. First, the thoracic surgeons performed an open-window thoracostomy. This procedure was followed by the definitive surgical treatment after 3-6 months. In cases with an additional bronchial insufficiency, the stump was covered in with a subscapularis muscle. The infraspinatus and the teres muscle group were used to fill the pleural cavity, in combination with the thoracoplasty.
RESULTS: In this series, no mortality connected to the procedure was noted. The mean postoperative stay in the intensive care unit (ICU) was 3±2.9 days and the patients were discharged from the hospital after 15±7.6 days. Minor postoperative complications occurred in two cases. Shoulder abduction in all patients was possible up to 90° and has decreased around 15±10° postoperatively.
CONCLUSIONS: The division of the thoracodorsal pedicle and the consecutive loss of the latissimus as a reconstructive option remain challenging. The lower shoulder girdle muscles (infraspinatus, subscapularis, teres minor and major) are an adequate alternative for filling residual empyema spaces. The constraint in shoulder movement is minor and acceptable in such situations.
P Fuchs; W Schreiner; T P Wolter; R Autschbach; H Sirbu; N Pallua
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Publication Detail:
Type:  Journal Article     Date:  2010-06-16
Journal Detail:
Title:  Journal of plastic, reconstructive & aesthetic surgery : JPRAS     Volume:  64     ISSN:  1878-0539     ISO Abbreviation:  J Plast Reconstr Aesthet Surg     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101264239     Medline TA:  J Plast Reconstr Aesthet Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  335-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Department of Plastic Surgery and Hand Surgery, Burn Center, RWTH University of Aachen, Nordrhein-Westfalen, Germany.
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