The laparoscopically harvested omental flap and transverse plate fixation for sternal reconstruction in complicated sternal wound infection after cardiac surgery

Abstract

Methods Between 2010 and 2011, 6 patients with type IV deep sternal wound infection underwent a sternal reconstruction with a laparoscopically harvested omental flap and transverse plate fixation. The median age of the cohort (1 female and 5 males), was 72.5 years (range: 4978 years). In 5 patients, a bilateral internal thoracic artery had been used. Considerable preoperative risk factors were present: Obesity with Body Mass Index (BMI) ≥ 33 (range: 33 – 35: 3 patients); chronic obstructive pulmonary disease (COPD) without steroid therapy preoperatively (4 patients); Diabetes mellitus (type 1: 2 patients; type 2: 1 patient). Abdominal surgery had previously been performed in 4 patients. In 5 cases, the mediastinal wound was prepared with negative pressure wound therapy following surgical debridement. An internal fixation of the sternum was made by titanium locking plates with sternal and rib-to-rib fixation. The postoperative course of these patients was followed by clinical follow-up.