Omental transfer for deep sternal wound infection after coronary artery bypass grafting with the right gastroepiploic artery.

We have applied omental transfer in cases of deep sternal wound infection (DSWI) that occurred after the right gastroepiploic artery was used as a coronary artery bypass graft. Study subjects were 7 patients (mean age was 66 years) who underwent coronary artery bypass grafting with the right gastroepiploic artery during the period January 1990-March 2004, then suffered DSWI and underwent single-stage treatment consisting of debridement and omental transfer 33 days on average (range 12-93 days) after the primary surgery. Patients were followed-up, and the following data were collected in retrospect: clinical presentation and in-hospital and long-term results. Three of the 7 patients underwent omental transfer based on the left gastroepiploic artery alone, 3 underwent omental transfer based on blood supply from a branch of the right gastroepiploic artery, and 1 underwent omental transfer based on blood supply from both branches. The hospital mortality rate was 14% (1 of 7 patients); death was caused by recurrent mediastinitis. Postoperative hospitalization was 47 days (range 21-83 days). Two patients died of cardiac failure, and 1 patient suffered abdominal wall hernia during the follow-up period. Even after harvesting of the right gastroepiploic artery, omental transfer was effective for the treatment of DSWI.