Greig Aina V H, Geh Jenny L C, Khanduja Vikas, Shibu Mohammed
Department of Plastic and Reconstructive Surgery, Bart's and The London NHS Trust, Royal London Hospital, Whitechapel, London E1 1BB, UK.
J Plast Reconstr Aesthet Surg. 2007;60(4):372-8. doi: 10.1016/j.bjps.2006.10.005. Epub 2007 Jan 19.
Infection of a median sternotomy wound is a rare albeit potentially fatal complication because of the risk of mediastinitis and deep sternal wound infection. Current treatment of deep sternal wound infection comprises antibiotics, debridement and transposition of muscle or omental flaps to fill the anterior mediastinal dead space.
A retrospective analysis of the deep sternal wound infections treated in our unit over a nine-year period was performed.
Out of the 11 903 consecutive coronary artery bypass graft procedures performed, 27 patients were referred to plastic surgery for management of deep sternal wound infection with flaps. Wounds were classified based on their location on the sternum as type A (upper (1/2)), B (lower (1/2)) or C (whole of sternum). Five patients had type A wounds, 12 type B wounds and 10 type C wounds. The mean age was 68 years and the M:F ratio was 20:7. We describe guidelines for the choice of flap for sternal wound reconstruction, according to the anatomical site of the wound dehiscence.
正中胸骨切开术后伤口感染是一种罕见但可能致命的并发症，因为存在纵隔炎和深部胸骨伤口感染的风险。目前深部胸骨伤口感染的治疗方法包括使用抗生素、清创以及转移肌肉或网膜瓣以填充前纵隔的死腔。
对我们科室九年间治疗的深部胸骨伤口感染进行回顾性分析。
在连续进行的11903例冠状动脉搭桥手术中，有27例患者因深部胸骨伤口感染需皮瓣修复而被转诊至整形外科。伤口根据其在胸骨上的位置分为A 型（上半部分）、B型（下半部分）或C型（整个胸骨）。5例为A型伤口，12例为B型伤口，10例为C型伤口。平均年龄为68岁，男女比例为20:7。我们根据伤口裂开的解剖部位描述了胸骨伤口重建皮瓣选择的指导原则。
