title: One-stage management of infected sternotomy wounds using bilateral pectoralis major myocutaneous advancement flap.
abstract: OBJECTIVE
  To assess the results of single-stage treatment of infected sternotomy wounds using bilateral pectorals major myocutaneous advancement flaps.
  
  
  METHODS
  Between January 2000 and July 2007, 1972 heart surgeries with median transesternal thoracotomy were performed. Thirteen (0.65%) patients presented wound infections and dehiscence after sternotomy. To treat those patients we adopted exclusively single-stage management, drainage, early intervention and immediate wounds closure using bilateral pectoralis major myocutaneous advancement flaps to the medium line of the sternum. Two patients with superficial wounds infection and other two who underwent torsion adjustment of the steel wire were not included in this study.
  
  
  RESULTS
  There was one death in the 30-day postoperative period. There was no intraoperative death. Four patients needed additional surgical intervention to drain residual seroma or local infection. There was total resolution of the sternal infection in 12 patients.
  
  
  CONCLUSIONS
  The authors recommend the single-stage early management of sternotomy infected wounds with debridement, drainage and immediate closure of the wound using bilateral pectoralis major myocutaneous advancement flaps to the medium line of the sternum. The procedure is effective and may contribute to decrease the morbidity.
authors.affiliation: Faculty of Medicine of Federal University ofRio de Janeiro, RJ, Brasil. joaobrito@uol.com.br
authors.forename: João de Deus e
authors.initials: Jde D
authors.lastname: Brito
authors.forename: Claudio Roberto
authors.initials: CR
authors.lastname: Assumpção
authors.forename: Henrique
authors.initials: H
authors.lastname: Murad
authors.forename: Antonio de Pádua
authors.initials: Ade P
authors.lastname: Jazbik
authors.forename: Mauro Paes Leme de
authors.initials: MP
authors.lastname: Sá
authors.forename: Eduardo Sergio
authors.initials: ES
authors.lastname: Bastos
authors.forename: Rubens
authors.initials: R
authors.lastname: Giambroni Filho
authors.forename: Renato
authors.initials: R
authors.lastname: Souza e Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000379:methods; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery*; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013249:Sternum / Q000601:surgery*; D013524:Surgical Flaps; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013530:Surgical Wound Infection / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult