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Omentum flap as a salvage procedure in deep sternal wound infection
INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574694/ https://www.ncbi.nlm.nih.gov/pubmed/28883736 http://dx.doi.org/10.2147/TCRM.S134869 |
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author | Spindler, Nick Etz, Christian D Misfeld, Martin Josten, Christoph Mohr, Friedrich-Wilhelm Langer, Stefan |
author_facet | Spindler, Nick Etz, Christian D Misfeld, Martin Josten, Christoph Mohr, Friedrich-Wilhelm Langer, Stefan |
author_sort | Spindler, Nick |
collection | PubMed |
description | INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs. Omentoplasty was performed in combination with a split skin graft and the wound was closed by a vacuum-assisted therapy for 7 days. The patients’ sex and comorbid risk factors supporting DSWIs as well as the postoperative complications were recorded. RESULTS: Retrospective analysis of 14 patients (10 males and four females) after a follow-up time of 24 months was performed. The average age was 75 years (range: 67–83). Heart surgery took place electively in eight cases, in three cases urgently and three for emergency reasons. The preoperative Euro Score was 16 (range 3.51–42.58). We had no flap loss in any patients. The skin graft showed a full take in all patients. Two patients needed revision of an abdominal wound dehiscence after laparotomy and one patient developed hernia in the late outcome. DISCUSSION: The greater omentum flap has, over many years, become an ideal partner in the coverage and treatment of DSWIs. Especially due to its immunologic capacity and amorphous structure, it has the ability to fill up cavities and cover infected artificial material so residual infections can be controlled. |
format | Online Article Text |
id | pubmed-5574694 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-55746942017-09-07 Omentum flap as a salvage procedure in deep sternal wound infection Spindler, Nick Etz, Christian D Misfeld, Martin Josten, Christoph Mohr, Friedrich-Wilhelm Langer, Stefan Ther Clin Risk Manag Original Research INTRODUCTION: Deep sternal wound infections (DSWIs) are rare but devastating complication after median sternotomy following cardiac surgery. Especially in the presence of artificial material or inadequate preliminary muscle flaps, the pedicled omentum flap is due to its immunological properties, the predetermined flap in salvage procedures. METHODS: We treated 14 patients suffering a mediastinitis and open thorax using a pedicled omentoplasty as a salvage procedure because of persisting DSWIs. Omentoplasty was performed in combination with a split skin graft and the wound was closed by a vacuum-assisted therapy for 7 days. The patients’ sex and comorbid risk factors supporting DSWIs as well as the postoperative complications were recorded. RESULTS: Retrospective analysis of 14 patients (10 males and four females) after a follow-up time of 24 months was performed. The average age was 75 years (range: 67–83). Heart surgery took place electively in eight cases, in three cases urgently and three for emergency reasons. The preoperative Euro Score was 16 (range 3.51–42.58). We had no flap loss in any patients. The skin graft showed a full take in all patients. Two patients needed revision of an abdominal wound dehiscence after laparotomy and one patient developed hernia in the late outcome. DISCUSSION: The greater omentum flap has, over many years, become an ideal partner in the coverage and treatment of DSWIs. Especially due to its immunologic capacity and amorphous structure, it has the ability to fill up cavities and cover infected artificial material so residual infections can be controlled. Dove Medical Press 2017-08-23 /pmc/articles/PMC5574694/ /pubmed/28883736 http://dx.doi.org/10.2147/TCRM.S134869 Text en © 2017 Spindler et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Spindler, Nick Etz, Christian D Misfeld, Martin Josten, Christoph Mohr, Friedrich-Wilhelm Langer, Stefan Omentum flap as a salvage procedure in deep sternal wound infection |
title | Omentum flap as a salvage procedure in deep sternal wound infection |
title_full | Omentum flap as a salvage procedure in deep sternal wound infection |
title_fullStr | Omentum flap as a salvage procedure in deep sternal wound infection |
title_full_unstemmed | Omentum flap as a salvage procedure in deep sternal wound infection |
title_short | Omentum flap as a salvage procedure in deep sternal wound infection |
title_sort | omentum flap as a salvage procedure in deep sternal wound infection |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574694/ https://www.ncbi.nlm.nih.gov/pubmed/28883736 http://dx.doi.org/10.2147/TCRM.S134869 |
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