Deep sternal wound infection – latissimus dorsi flap is a reliable option for reconstruction of the thoracic wall View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-11-21

AUTHORS

Nick Spindler, Stefanie Kade, Ulrich Spiegl, Martin Misfeld, Christoph Josten, Friedrich-Wilhelm Mohr, Michael Borger, Stefan Langer

ABSTRACT

BackgroundAt present, data describing patients’ long-term outcomes, quality of life, and survival after deep sternal wound infection are rarely available.The purpose of our study was to evaluate functional outcome and patient well-being after debridement and reconstruction of the sternal defect using a pedicled latissimus dorsi flap following deep sternal wound infection (DSWI).MethodsThis retrospective analysis reviewed 106 cases of DSWI after open-heart surgery treated between May 1, 2012, and May 31, 2015. The parameters of interest were demographic and medical data, including comorbidity and mortality. Follow-up consisted of physical examination of the patients using a specific shoulder assessment, including strength tests and measurements of pulmonary function.ResultsThe population consisted of 69 (65%) male and 37 (35%) female patients. Their average age at the time of plastic surgery was 69 years (range: 35–85). The 30-day mortality was 20% (n = 21); after one-year, mortality was 47% (n = 50), and at follow-up, it was 54% (n = 58).Heart surgery was elective in 45 cases (42%), urgent in 31 cases (29%) and for emergency reasons in 30 cases (28%). The preoperative European System for Cardiac Operative Risk Evaluation (EuroSCORE) averaged 16.3 (range: 0.88–76.76).On the dynamometer assessment, a value of 181 Newton (N) (±97) could be achieved on the donor side, in contrast to 205 N (±91) on the contralateral side.The inspiratory vital capacity of the lung was reduced to an average of 70.58% (range: 26–118), and the forced expiratory volume in 1 s was decreased to an average of 69.85% (range: 38.2–118).ConclusionsGiven that only small adverse effects in shoulder function, strength, and pulmonary function were observed, the latissimus dorsi flap appears to be a safe and reliable option for the reconstruction of the sternal region after DSWI. More... »

PAGES

173

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12893-019-0631-4

DOI

http://dx.doi.org/10.1186/s12893-019-0631-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1122782453

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31752814


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