K. Yasuura et al., THE OMENTAL FLAP WITH SKIN-GRAFTING FOR TREATMENT OF A DIFFICULT STERNAL CLOSURE, The thoracic and cardiovascular surgeon, 45(3), 1997, pp. 138-140
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.