Vlajcic Zlatko, Zic Rado, Stanec Sanda, Stanec Zdenko
Department of Plastic Surgery, University Hospital Dubrava, Zagreb, Croatia.
Scand J Plast Reconstr Surg Hand Surg. 2007;41(3):114-9. doi: 10.1080/02844310701214479.
The treatment of sternal wound infection still carries a high mortality. Treatment preferences range from more conservative treatments that do not include flaps, to more aggressive reconstructions using different types of flaps, and these could be resolved and standardised using a proper classification with a treatment algorithm. We propose modification of the existing classification, with different proposals for treatment, stressing the importance of the radicality of debridement, and report our results in 31 patients, 24 of whom were well satisfied. Eleven were left with some pain in the chest wall, and eight each with some muscular weakness and less than adequate cosmesis. We would also like to recommend the omental flap as the first choice for selected cases. With our selective approach we have achieved good functional and aesthetic results with satisfied patients.
胸骨伤口感染的治疗死亡率仍然很高。治疗方法的选择范围很广，从不包括皮瓣的较为保守的治疗方法，到使用不同类型皮瓣的更为积极的重建方法，而通过采用带有治疗算法的适当分类，这些方法可以得到解决和标准化。我们建议对现有分类进行修改，并提出不同的治疗方案，强调清创彻底性的重要性，并报告我们对31例患者的治疗结果，其中24例患者非常满意。11例患者胸壁仍有一些疼痛，8例患者有肌肉无力，且美容效果欠佳。我们还建议对于某些特定病例，网膜瓣应作为首选。通过我们的选择性治疗方法，我们取得了良好的功能和美学效果，患者满意度较高。
