Milano C A, Georgiade G, Muhlbaier L H, Smith P K, Wolfe W G
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Ann Thorac Surg. 1999 Feb;67(2):377-80; discussion 380-1. doi: 10.1016/s0003-4975(99)00022-3.
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.
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.
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.
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.
胸大肌皮瓣常用于治疗胸骨切开术后纵隔炎。我们比较了大网膜转移术（纵隔炎的一种替代治疗方法）与胸大肌皮瓣治疗的效果。
将接受单纯大网膜皮瓣治疗胸骨切开术后纵隔炎的患者（n = 21）与一组连续接受胸大肌皮瓣治疗的患者（n = 38）进行比较。两组的基线特征相当，对早期和晚期结果均进行了比较。
接受大网膜皮瓣治疗的组手术时间和术后住院时间显著缩短，早期并发症明显减少。此外，大网膜皮瓣组没有早期或晚期皮瓣坏死或脓肿发生。
本研究发现，大网膜皮瓣改善了早期结果，相对于胸大肌皮瓣，是治疗胸骨切开术后纵隔炎更有效的疗法。文中给出了可优化结果的大网膜转移术的技术要点。
