REDUCTION MAMMAPLASTY COMBINED WITH PECTORALIS MAJOR MUSCLE FLAPS FORMEDIAN STERNOTOMY WOUND CLOSURE

Sternal wound infection can be a problem in patients who undergo coron ary artery bypass graft surgery and is usually treated with local flap s. Severe macromastia can cause a large wound dehiscence by inferolate ral tension on the skin sutures. Chest wall reconstruction can be achi eved by combining muscle flap coverage with reduction mammaplasty. Two musculoglandulocutaneous flaps can be designed, using two superiorly based pectoralis muscle flaps vascularising the medial portion of the glandular breast tissue. The flaps are advanced medially to the sterne ctomy site and the breast reduction is then completed by adjusting the lateral breast pillar to the medial breast pillar. A case in which th is technique was successfully used is reported.