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联合真空辅助封闭治疗与腹腔镜网膜瓣动员及网状皮肤移植重建感染性胸骨切开伤口:两例报告

Combined vacuum-assisted closure treatment with laparoscopic mobilization of an omental flap and meshed skin grafts for reconstruction of infected sternotomy wounds: two cases.

作者信息

Veir Zoran, Smud Sanda, Bogdanić Branko, Cvjeticanin Bruno, Bagatin Dinko, Dujmović Anto, Duduković Mladen, Ivrlac Radojko, Bulić Kresimir, Mijatović Davor

机构信息

Department of Plastic Surgery, University Hospital Center Zagreb, Zagreb, Croatia.

出版信息

Coll Antropol. 2009 Dec;33(4):1427-30.

Abstract

In cardiac surgery, poststernotomy wounds are life threatening complications, with mortality up to 50%. We described two patients, who underwent coronary artery bypass grafting and postoperatively developed a deep sternal wound infection. Reconstruction was combined with vacuum-assisted closure treatment, laparoscopic mobilization of an omental flap and split thickens skin grafts. The omental flap is a well-vascularized local flap with a large surface area and has excellent immunologic and angiogenic properties. Both patients recovered completely. In our opinion, vacuum-assisted closure treatment and laparoscopic mobilization of great omentum is suitable option for treating deep sternal wounds.

摘要

在心脏外科手术中,胸骨切开术后伤口是危及生命的并发症,死亡率高达50%。我们描述了两名接受冠状动脉搭桥手术的患者,术后发生了深部胸骨伤口感染。重建手术结合了负压封闭引流治疗、腹腔镜网膜瓣动员和中厚皮片移植。网膜瓣是一种血运丰富的局部皮瓣,表面积大,具有优异的免疫和血管生成特性。两名患者均完全康复。我们认为,负压封闭引流治疗和腹腔镜大网膜动员是治疗深部胸骨伤口的合适选择。

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