THE OMENTAL FLAP WITH SKIN-GRAFTING FOR TREATMENT OF A DIFFICULT STERNAL CLOSURE

A case report of difficult sternal closure is described. Chest closure following cardiac operation in critically ill patients can be a probl em. Techniques have been described so that sternal closure can be dela yed until the patient is hemodynamically stable and hemostasis has bee n achieved. However, in some instances, the sternal closure can not be performed because of prolonged cardiopulmonary instability. We descri be the use of transpostion of an omental flap with skin grafting in a 74-year-old patient with aortic valve stenosis, poor pulmonary functio n, and a thoracic deformity. This technique enabled incomplete sternal closure which maintained hemodynamic stability.