[Reconstruction of a thoracic wall defect using a flap of omentum obtained by laparoscopy].
Reconstructive of complex chest wall defects following infected sternotomy represents a surgical challenge. Several options were described for these defects reconstructions, using muscles flaps and omentum which provided obliteration of dead space and coverage. We present a reconstruction of a major chest and abdominal wall defect in a 62-year old patient, who had mediastinitis, osteomyelitis and necrosis of sternum after myocardial revascularization. The pectoralis major was used unsuccessfully, with total loose of the flap. After wound failure, a flap of omentum based on the left gastroepiploic vessels was obtained by a laparoscopic surgery, with no complication. The omentum was translocated through the defect that reached the abdominal wall covering the defect and allowing the use of split-thickness grafts. The laparoscopic procedure showed advantages over the laparotomy in the management of omentum, with the same results in the reconstruction of the defect added the advantages of a minimal invasive procedure, mainly in patient with bad clinical conditions.
Domene
C E
CE
Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo.
Volpe
P
P
Onari
P
P
Birbojm
I
I
Szachnowicz
S
S
Barreira
L F
LF
Reiff
A M
AM
Pinotti
H W
HW
D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013909:Thorax