SINGLE-STAGE TREATMENT OF STERNAL WOUND COMPLICATIONS IN HEART-TRANSPLANT RECIPIENTS IN WHOM PECTORALIS MAJOR MYOCUTANEOUS ADVANCEMENT FLAPS WERE USED

Treatment of sternal wound complications is controversial, particularl y in immunosuppressed heart transplant recipients, Regardless of the s everity of infection, we combine immediate, aggressive debridement wit h bilateral pectoralis major myocutaneous advancement flaps in a singl e procedure, Compared with management with pectoralis major turnover f laps or distant pedicled muscle flaps, treatment of these sternal woun ds with pectoralis major myocutaneous advancement flaps is simpler and quicker and provides better aesthetic results, Furthermore, because p ectoralis major myocutaneous flaps are based on the thoracoacromial ar teries, whether or not the internal mammary arteries have previously b een harvested for coronary grafts is irrelevant, Twenty consecutive he art transplant recipients with sternal wound complications were treate d with this technique, No intraoperative or perioperative deaths occur red. The morbidity rate was 30%, with seroma treated by needle aspirat ion in four patients (20%) being the most common complication, Only on e patient had a postoperative wound infection, All patients had excell ent functional and aesthetic results.