Levy Adam S, Ascherman Jeffrey A
Division of Plastic Surgery, Department of Surgery, Columbia University Medical Center, New York, N.Y.
Plast Reconstr Surg Glob Open. 2019 Nov 27;7(11):e2488. doi: 10.1097/GOX.0000000000002488. eCollection 2019 Nov.
Sternal wounds and associated infections represent a complex reconstructive problem in a highly morbid patient population. Through strict adherence to excellent plastic surgical principles, this process can be simplified, allowing safe and effective wound closure. Emphasis is placed on thorough debridement, hardware removal, obtaining adequate tissue cultures, and finally, appropriate flap closure. In most cases, pectoralis major myocutaneous advancement flaps provide excellent coverage while eliminating dead space and providing sternal compression. Secondary flap options, such as the omental flap or rectus abdominis muscle, may occasionally be necessary. This article will provide an overview and simplified approach to sternal wound reconstruction.
胸骨伤口及相关感染在病情严重的患者群体中是一个复杂的重建问题。通过严格遵循出色的整形外科原则,这一过程可以得到简化,实现安全有效的伤口闭合。重点在于彻底清创、取出内固定物、获取足够的组织培养样本,最后进行合适的皮瓣闭合。在大多数情况下,胸大肌肌皮推进皮瓣能提供良好的覆盖,同时消除死腔并对胸骨起到压迫作用。偶尔可能需要诸如网膜瓣或腹直肌等备用皮瓣选项。本文将概述胸骨伤口重建并提供简化方法。