Simple and reliable way in sternum wound coverage--tripedicle pectoralis major musculocutaneous flap.
OBJECTIVE
Sternotomy wound infection requires radically debridements and need secondary reconstruction of the resulting defect. Pectoralis major muscular or musculocutaneous flap is quite common in sternal wound closure. We modified the pectoralis major musculocutaneous flap design: bipedicle advancement cutaneous flap combined with thoracoacromial myocutaneous perforators, as a "tripedicle" fashion. We tried to utilize the cutaneous pedicle to provide a reliable skin coverage and decrease the wound dehiscence rate in lower one third sternal wound.


METHODS
Four patients undergoing median sternotomy surgery between 2004 and 2007 suffered from sternal wound infection and received tri-pedicle pectoralis major musculocutaneous flaps transfer.


RESULTS
No skin paddle necrosis or wound dehiscence occurred in the postoperative course. Cosmetically and chest stability were satisfactory without complains about the daily activity.


CONCLUSIONS
Tripedicle pectoralis major musculocutaneous flap is a simple and reliable technique to cover sternal wound defect necessitating resurfacing surgery. The blood supply to the skin paddle can be enriched by the superior and inferior cutaneous pedicle and the wound dehiscence rate is decreased with this technique.
Chou
Erh-Kang
EK
Department of Plastic and Reconstructive Surgery, China Medical University Hospital, Taichung, Taiwan. erkang27@yahoo.com.tw
Tai
Yu-Tzu
YT
Chen
Hung-Chi
HC
Chen
Kuang-Te
KT
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000098:blood supply / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000601:surgery; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D016896:Treatment Outcome