Simple pectoralis major myocutaneous advancement flaps for closure after sternal wound dehiscence

Between October 1994 and March 1996, 14 consecutive patients with a wound d ehiscence after median sternotomy for cardiac surgery were treated with pec toralis major myocutaneous advancement flaps. After thorough sternal wound debridement, the sternal edges were contoured to create a shallow defect. T his was to enable the obliteration of dead space between the mediastinum an d the flaps. The pectoralis muscle was then elevated off the chest wall, it s humeral attachment, the thoraco-acromial pedicle and the connection with the skin were left intact. Next, the bilateral myocutaneous flaps were adva nced medially and approximated to each other in the midline. The mean opera tion time was 140 min and the mean follow-up time was 10 months. Four patie nts developed minor complications. The advantage of this technique is its s implicity and the reduction in mean operation time.