Primary Treatment of the Infected Sternotomy Wound with Muscle Flaps

Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno e mediastino anterior em pós-operatório de esternotomia

“…A 3.05% incidence of sternal infections or mediastinitis is high if compared with those reported in some of the largest and most recent studies-values of approximately 1%, (6,18,22) although several others have reported incidences of up to 5%.…”

“…(2)(3)(4) A second operation for debridement and drainage, together with long-term hospitalization for antibiotic therapy and Aggressive treatment using muscle flaps or omentopexy in infections of the sternum and anterior mediastinum following sternotomy* Tratamento agressivo com retalho muscular e/ou omentopexia nas infecções do esterno mediastino anterior em pós-operatório de esternotomia a technique with which others have also obtained favorable results. (7,8,17,18) In 1980, one group of authors broadened this concept and reported their initial experience with muscle flaps in the treatment of infections following sternotomy-56% presented an inadequate response to treatment with closed mediastinal irrigation. (8) Morbidity was significantly reduced, and mortality decreased concomitantly with the reduction in length of hospital stay.…”

“…(9,(17)(18)(19)(20)(21) Early aggressive treatment has been recommended by various authors. Early diagnosis is considered to play a key role in therapeutic success in this severe infectious complication following sternotomy.…”

Partial Breast Necrosis After Myocardial Revascularization

“…9,10 Median sternotomy was performed in 7,949 women at the New York University Medical Center, and no breast necrosis was reported. 9 At that time however, the use of IMA for revascularization was unknown.…”

“…Nahai et al reported a wound complication rate of 1.6% in 15 595 median sternotomies and also no breast necroses. 10 There are 6 breast necrosis cases reported in the world literature.…”