Yuen J C, Zhou A T, Serafin D, Georgiade G S
Division of Plastic and Reconstructive Surgery, University of Arkansas for Medical Sciences, Little Rock 72205-7199, USA.
Ann Plast Surg. 1995 Dec;35(6):585-9. doi: 10.1097/00000637-199512000-00005.
Use of muscle and omental flaps has been shown to provide reliable reconstruction of infected median sternotomy wounds; however, few reports emphasize the long-term sequelae of the complication and its treatment. This study was performed to evaluate the long-term problems, including patient satisfaction and survival rate, in 88 patients with median sternotomy infections treated with muscle or omental flaps. Forty-two patients were available for long-term follow-up by telephone interview, with an average length of follow-up of 42 months. Forty-three percent complained of chronic chest wall pain or discomfort, and 45% complained of sternal instability. After pectoralis major muscle flap reconstruction in 32 patients, 25% complained of upper extremity weakness, and 56% complained of chest contour deformity. Delayed septic costochondritis or osteomyelitis occurred in 8%. Despite these unfavorable consequences, 72% and 83% of patients were satisfied with the cosmesis of the operation and the overall result, respectively. Furthermore, after hospital discharge, these patients seem to enjoy satisfactory longevity. By emphasizing the potential sequelae, further research interest may be stimulated in delineating their causes and in refining techniques of reconstruction.
已证明使用肌肉和网膜瓣可为感染的正中胸骨切开术伤口提供可靠的重建；然而，很少有报告强调该并发症的长期后遗症及其治疗。本研究旨在评估88例接受肌肉或网膜瓣治疗的正中胸骨切开术感染患者的长期问题，包括患者满意度和生存率。通过电话访谈对42例患者进行了长期随访，平均随访时间为42个月。43%的患者抱怨慢性胸壁疼痛或不适，45%的患者抱怨胸骨不稳定。在32例行胸大肌瓣重建术后，25%的患者抱怨上肢无力，56%的患者抱怨胸部轮廓畸形。8%发生了延迟性化脓性肋软骨炎或骨髓炎。尽管有这些不良后果，但分别有72%和83%的患者对手术的美容效果和总体结果感到满意。此外，出院后，这些患者似乎享有令人满意的寿命。通过强调潜在的后遗症，可能会激发进一步的研究兴趣，以明确其原因并改进重建技术。
