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Ann Thorac Surg 1995;60:1372-1375
© 1995 The Society of Thoracic Surgeons

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Articles

Soft-tissue reconstruction in thoracic surgery

Royal Brompton Hospital, London, United Kingdom

Accepted for publication June 9, 1995.

^* Address reprint requests to Dr Goldstraw, Royal Brompton Hospital, Sydeny St, London SW3 6NP, UK.

	Abstract

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Background.: Reconstructive techniques using omental and myocutaneous flaps are widely used in the treatment of infected sternotomy wounds. To illustrate their wider role in thoracic reconstruction, we have retrospectively reviewed our experience over the last 5 years.

Methods.: We used complex omental and myocutaneous flaps in 30 patients: 19 men and 11 women with a mean age of 53 ± 4 years (range, 43 to 75 years). In 18 patients, these techniques were used to provide softtissue cover after chest wall resection, and in 12 cases complex myocutaneous flaps were used to obliterate chronic intrathoracic cavities. Rectus muscle was used in 11 of 24 muscle flaps, and omentum was used in 12 cases. There were 23 rotational flaps and seven free myocutaneous flaps with microvascular anastomosis.

Results.: There were no operative deaths, and there were three complications. In 2 patients with infected lesions, loss of the free flap required subsequent revision. In 1 patient, infection developed underneath a prosthesis, which was treated with drainage and rib resection. In all other cases, the primary aim of the operation was achieved without complications.

Conclusions.: The vascularity of the omentum should encourage its wider use, especially when infection exists preoperatively. Excellent results can be achieved when using the rectus muscle as a complex myocutaneous flap. The use of free flaps should be reserved for difficult cases and used only in the absence of infection.

	References

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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Al-Kattan, K. M. Articles by Goldstraw, P. Search for Related Content PubMed PubMed Citation Articles by Al-Kattan, K. M. Articles by Goldstraw, P.