Sjm. Jongen et al., PECTORALIS MAJOR MUSCLE TRANSPOSITION FOR TREATMENT OF INFECTED MEDIAN STERNOTOMY WOUNDS, European journal of plastic surgery, 18(2-3), 1995, pp. 103-107
Median sternotomy, currently the standard incision in open heart proce
dures, is rarely complicated by wound infection, but when present, it
is associated with a high morbidity and mortality. Adequate treatment
can be provided by means of transposition of the pectoralis major musc
le, After thorough sternal wound debridement the muscle, based on the
thoraco-acromial pedicle, is transposed into the defect. From Septembe
r 1986 until December 1992 14 patients (mean age 67 years) with sterna
l infection were treated using this technique. Mean hospital stay afte
r operation was 23 days; mean follow-up was 24 months, In 10 patients
(72%) a successful treatment, i.e. a permanently cured infection, was
achieved. Three patients (21%) developed a recurrence; one of them die
d during follow-up as a consequence of cardiac failure, the other two
underwent reoperation and healing occurred at a later stage. In one pa
tient (who died of a unknown cause 2 months after muscle transposition
) the result was classified as unknown. In conclusion, transposition o
f the pectoralis major muscle is an adequate treatment for severe ster
nal infections. In comparison with conservative methods, mortality and
morbidity can be reduced and hospital stay can be shortened.