Thoracic reconstruction with the omentum: Indications, complications, and results

This study provides a retrospective analysis of 60 patients who underwent t horacic reconstruction with the omentum. Patients were identified by search ing several databases to determine demographics, indications for surgery, o perative technique, and postoperative course, including donor and recipient site morbidity. From January 1975 to May 2000, the authors harvested and t ransferred the omentum successfully (57 pedicled, 3 free) in 60 patients (m ean age, 60 years; age range, 21-86 years) for sternal wound infections (N = 34), chest wall resections (N = 17), pectus deformities (N = 2), intratho racic defects (N = 4), and breast reconstruction (N = 3). The omentum was u sed as a primary flap in 39 patients and as a salvage flap in 21 patients. Average operative time was 3.9 hours and average hospital stay was 34.3 day s. Partial flap loss occurred in 7 patients, with no total flap failures. M orbidity included six abdominal wound infections and seven epigastric herni as. Mortality was 11.7%. The omentum can be harvested safely and used relia bly to reconstruct varying thoracic wounds and defects. Specific indication s from this series include osteoradionecrosis, chest wall tumors, massive s ternal wounds, and refractory mediastinitis.