Comparison of omental and pectoralis flaps for poststernotomy mediastinitis.
BACKGROUND
Pectoralis flaps are frequently used to treat poststernotomy mediastinitis. We compared the outcomes of omental transfer, an alternative treatment for mediastinitis, with those of pectoralis flaps.


METHODS
Patients treated for poststernotomy mediastinitis with isolated omental flaps (n = 21) were compared with a group of consecutive patients treated with pectoralis flaps (n = 38). Baseline characteristics were equivalent for the two groups, and both early and late outcomes were compared.


RESULTS
Length of procedure and length of postoperative hospitalization were reduced significantly and there were significantly fewer early complications in the group treated with omental flaps. Furthermore, there were no early or late flap failures or abscesses in the omental flap group.


CONCLUSIONS
This study found that omental flaps had improved early outcomes and are a more effective therapy relative to pectoralis flaps for poststernotomy mediastinitis. Technical considerations for omental transfer that could optimize results are given.
Milano
C A
CA
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Georgiade
G
G
Muhlbaier
L H
LH
Smith
P K
PK
Wolfe
W G
WG
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D008297:Male; D008480:Mediastinitis / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome