title: [Reconstruction of a thoracic wall defect using a flap of omentum obtained by laparoscopy].
abstract: 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.
authors.affiliation: Departamento de Gastroenterologia da Faculdade de Medicina da Universidade de São Paulo.
authors.forename: C E
authors.initials: CE
authors.lastname: Domene
authors.forename: P
authors.initials: P
authors.lastname: Volpe
authors.forename: P
authors.initials: P
authors.lastname: Onari
authors.forename: I
authors.initials: I
authors.lastname: Birbojm
authors.forename: S
authors.initials: S
authors.lastname: Szachnowicz
authors.forename: L F
authors.initials: LF
authors.lastname: Barreira
authors.forename: A M
authors.initials: AM
authors.lastname: Reiff
authors.forename: H W
authors.initials: HW
authors.lastname: Pinotti
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D013909:Thorax