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Ann Thorac Surg 2000;70:1449
© 2000 The Society of Thoracic Surgeons

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Correspondence

Reoperation through a previous pectoralis muscle flap in an infant

Department of Surgery, Medical University of South Carolina, 96 Jonathan Lucas St, Suite 409, Charleston, SC, USA 29425,

e-mail: crawfrdf{at}musc.edu

To the Editor

Erez and coauthors recently reported on the use of pectoralis major muscle flaps in 6 neonates and 3 infants who developed deep sternotomy wound infections [1]. None of these patients required reoperation, and the authors speculate in their discussion as to whether this would be feasible in infants and whether there would be an increased risk. In 1989, we reported a 1-month-old malnourished 2-kg infant who underwent pulmonary artery banding because of a large ventricular septal defect [2]. The infant subsequently developed mediastinitis, which was managed by transposing the right pectoralis major and the right rectus abdominus into the chest wall defect after it had been debrided. Subsequently, the patient underwent removal of the pulmonary artery band and ventricular septal defect repair, and at the time of reoperation through the reconstructed chest wall, "a thick layer of fibrocartilaginous tissue was encountered from beneath which pericardium and ventricular wall were easily separated." The wound healed uneventfully, the chest wall was stable, and the child has subsequently grown normally and continues to do well.

We bring this to the authors’ and other readers’ attention simply to point out that in at least one instance, reoperation in an infant through a pectoralis major flap was uneventful and was followed by a good long-term result.

References

1. Erez E., Katz M., Sharoni E., et al. Pectoralis major muscle flap for deep sternal wound infection in neonates. Ann Thorac Surg 2000;69:572-577.[Abstract/Free Full Text]
2. Terranova W, Crawford FA, Jr. Treatment of median sternotomy wound infection and sternal necrosis in an infant. Ann Thorac Surg 1989;48.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Fred A. Crawford, Jr Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Crawford, F. A. Search for Related Content PubMed Articles by Crawford, F. A., Jr Related Collections Related Article