Treatment of XXXX using an open irrigation and delayed sternal reconstruction with a pectoralis major muscle flap.

@entity1 @entity1764 @entity281 @entity292 @entity158
BACKGROUND: @entity1764 is a very serious complication after cardiac surgery. To date, the optimal treatment of @entity1764 is still controversial: the "closed wound" procedures and the "open wound" treatments are the two conventional modalities reported in the literature. METHODS: Between January 1995 and December 2000, 20 @entity1 , who had previously been submitted to cardiac surgery, were treated by a modification of the "open wound" treatment strategy for postoperative @entity1764 . All @entity1 were scheduled for 2, 6, and 12-month clinical follow-up. The procedure performed consisted of three major steps: 1) early sternum reopening, followed by phase 2) including irrigation of the wound 3 times daily, and the final step 3) of delayed reconstructive surgery using the pectoralis major myocutaneous advancement flap closure technique. We prospectively analyzed the short- and long-term results of these procedures. RESULTS: The overall duration of hospitalization was 25 +/- 10 days; no @entity1 required intensive care unit permanency. Clinical success was achieved in all 20 cases (100%). No recurrences of local (such as @entity292 or abscesses) or @entity281 were noted, and no @entity1 required sternal reopening during follow-up. An optimal cosmetic result was obtained in all @entity1 and only 2 cases had persistent sternal @entity158 regressing at the 6-month follow-up control. CONCLUSIONS: Our data suggest that for @entity1 with severe @entity1764 , this treatment strategy is safe. The clinical and esthetic success rates are high, the recovery time rapid, and the rates of short- and long-term complications very low.
