Novel surgical integration technique in ravitch procedure using an atraumatic o-ring wound retractor: case report

Abstract

Modified Ravitch procedure is the hallmark surgical procedure to repair pectus deformities, manual and auto self-retaining metal retractors are very helpful because they grant and maintain the surgical site exposure. However, these metal retractors often have sharp tips that are capable of causing soft tissue flaps damage. In abdominal surgery, using an atraumatic O-ring wound retractor has been associated with diminution of superficial surgical site complications and post-operative pain reduction due, these suggested benefits can be reproducible in modified Ravitch procedure. A 20-year-old male patient is referred to our service for presenting chest discomfort and body image issues. Subsequent work up revealed a pectus carinatum without associated congenital heart disease. A transverse infra-mammary skin 8 cm incision was made. We used an atraumatic O-ring wound retractor to expose surgical site and performed bilateral subperichondrial abnormal costal cartilages resection with sternum wedge osteotomy. Drains was removed in 24 hours, and the post-surgical hospital stay was 72 hours. In this case, using an atraumatic O-ring wound retractor improved exposure with shorter incision, facilitated stable access to the costal cartilage, protecting the skin from injury, and reduced the administration of intravenous analgesics.