Laparoscopic greater omentum harvesting with split-thickness skin grafting for sternal wound dehiscence.
Sternal wound dehiscence is a serious complication occasionally requiring soft tissue coverage. The greater omentum typically has been used as a last resort because of the underlying morbidity from a laparotomy. We present a case in which a laparoscopically created omental flap with subsequent split-thickness skin grafting was used to correct a large soft tissue defect that occurred after sternal wound dehiscence developed. A nonambulatory 49-year-old man who underwent coronary artery bypass grafting developed sternal wound dehiscence. Because a large soft tissue defect developed after multiple debridements, soft tissue coverage was required. A laparoscopically harvested omental flap spared this man's upper extremity musculature and provided a soft tissue bed for split-thickness skin grafting. This case helps to establish the role of laparoscopically harvested omentum. If the results suggested by this case are confirmed in a large series, omental flaps should be considered as options of first choice in the management of sternal wound dehiscence.
Barragan
Barnard A
BA
Division of General Surgery, Department of Surgery, Texas Tech University Health Sciences Center, Lubbock 79415, USA.
Halldorsson
Ari O
AO
Wachtel
Mitchell S
MS
Frezza
Eldo E
EE
D001026:Coronary Artery Bypass; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D013249:Sternum; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000601:surgery*