Modification of Rotation-Advancement Split Pectoralis Major (RASP) Turnover Flap Technique for Median Sternotomy Wound Dehiscence.

Abstract

Pectoralis major muscle flap was used alone or mostly combined with rectus muscle or omentum to cover the whole sternal defect.[1] [2] [3] Disadvantages are additional abdominal incisions, herniation of bowel, introducing infection to abdominal cavity. D. A. Staffenberg introduced “Rotation-Advancement Split Pectoralis (RASP) major muscle turnover flap” technique for median sternotomy wound dehiscence.[4] In his technique, one-side split pectoralis major muscle flap was turned over based on internal mammary artery perforators and the other side pectoralis muscle flap advanced to the defect based on thoracoacromial pedicle. In our technique, we modified the split pectoralis muscle upper flap that was islanded based on the thoracoacromial pedicle to achieve more mobilization, less bulging contour deformity, and use the dominant blood supply.