Francel T J, Kouchoukos N T
Department of Surgery, St. Louis University, and St John's Mercy Medical Center, Missouri, USA.
Ann Thorac Surg. 2001 Oct;72(4):1419-29. doi: 10.1016/s0003-4975(00)02009-9.
One hundred fifty-one patients were reconstructed after median stemotomy by a single plastic surgeon over a 6-year period. The treatment included immediate reconstruction (63 patients) and delayed reconstructions (88 patients). Ninety eight percent of the patients had definitive healing at 6 weeks with an overall 30-day mortality of 4 percent. The issues of long-term intravenous antibiotics, perceived skin deficiency, cardiac decompensation, Candida infections, and reexploration of a healed mediastinum after flap reconstruction are discussed. Follow up (4 months to 6 years) of patients treated with reconstruction compared favorably with patients treated with rewiring procedures (20 patients) in regard to strength, chest wall stability, pulmonary function testing, and functional return to hobbies and employment.
在6年时间里，由一位整形外科医生对151例患者进行了正中胸骨切开术后重建。治疗包括即刻重建（63例患者）和延迟重建（88例患者）。98%的患者在6周时实现了确定性愈合，30天总死亡率为4%。讨论了长期静脉使用抗生素、感觉皮肤缺损、心脏代偿失调、念珠菌感染以及皮瓣重建后愈合纵隔再次探查等问题。在力量、胸壁稳定性、肺功能测试以及恢复爱好和工作的功能方面，接受重建治疗的患者随访（4个月至6年）情况优于接受重新布线手术的患者（20例）。
