title: [Plastic surgery coverage of osteocutaneous defects of the sternum area with the vertical and transversal rectus abdominis muscle (VRAM/TRAM) flap].
abstract: Longitudinal osteocutaneous defects of the sternal region including the caudal third were reconstructed in 15 patients during a 3-year period by using the "vertical (VRAM)- and transverse rectus abdominis muscle" (TRAM) flap. The majority of the defects resulted from chronic osteomyelitis after previous cardiothoracic surgery or were due to former therapy of breast cancer. Three VRAM/TRAM flaps were primarily transferred as free flaps with microvascular anastomosis in the axilla region. Nine out of 12 pedicled VRAM or TRAM flaps required an additional microvascular anastomosis because of imminent venous or arterial insufficiency ("supercharging"). Therefore, operative technique and operating time of the pedicled and free flap for reconstruction of longitudinal sternal defects are comparable. Adequate reconstruction and rehabilitation was achieved in 11 cases. In 2 patients revision and partial secondary defect coverage was required. Two male patients died postoperatively due to their preexisting condition.
authors.affiliation: Abteilung für Verbrennungen, Plastische und Handchirurgie, BG Unfallklinik Ludwigshafen. Detlev.Erdmann@uvz.uni_heidelberg.de
authors.forename: D
authors.initials: D
authors.lastname: Erdmann
authors.forename: M
authors.initials: M
authors.lastname: Küntscher
authors.forename: A
authors.initials: A
authors.lastname: Petracic
authors.forename: M
authors.initials: M
authors.lastname: Sauerbier
authors.forename: H
authors.initials: H
authors.lastname: Menke
authors.forename: J
authors.initials: J
authors.lastname: Schirren
authors.forename: H
authors.initials: H
authors.lastname: Dienemann
authors.forename: G
authors.initials: G
authors.lastname: Germann
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery; D012086:Reoperation; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery