Açık Kalp Cerrahisi Sonrası Oluşan Göğüs Ön Duvarı Yumuşak Doku Defektlerinin Pektoral Kas Flebi ile Rekonstrüksiyonu

Öz

Amaç: Açık kalp cerrahisi sonrası görülen sternal yara enfeksiyonu ve buna bağlı gelişen yumuşak doku defekti morbitide ve mortaliteyi artıran ağır bir komplikasyondur. Bu makalede , açık kalp cerrahisi geçirmiş olan ve sonrasında mediyan sternal insizyon hattında gelişen enfeksiyon nedeni ile göğüs ön duvarında yumuşak doku defekti oluşan hastaların pektoralis majör kas flep ile rekonstrüksiyonu sunulmuş ve tecrübelerimiz aktarılmıştır. Gereç ve Yöntemler: 2012-2017 yılları arasında toplam 7 hastaya, açık kalp cerrahisi sonrası sternal insizyon hattında gelişen enfeksiyon sonrası oluşan göğüs ön duvarı yumuşak doku defektlerine pektoralis majör kas flebi ile rekonstrüksiyon uygulanmıştır.Bulgular: 1 hastada erken dönem hematom oluştu ve tekrar operasyona alındı. 1 hastada flep üzerine konulan deri greftinde kısmi kayıp oluştu ve tekrar uyluktan alınan kısmi kalınlıkta deri grefti ile defekt kapatıldı. Diğer hastalarda yara iyileşmesi problemi gözlenmedi ve tam iyileşme sağlandı. Sonuç: Sonuç olarak; açık kalp cerrahisi sonrası gelişen göğüs ön duvarı yumuşak doku defektlerinde, yeterli debridman ile birlikte pektoral kas flebi ile onarım uygun olgularda etkili ve güvenilir bir yöntemdir

Anahtar Kelimeler

• Göğüs ön duvarı defekti, Pektoralis majör kas flebi, Sternal yumuşak doku defekti

Reconstruction with Pectoralis Muscle Flap of Soft Tissue Defect of Anterior Chest Wall Following Open Heart Surgery

Abstract

Objective: The sternal wound infection following open heart surgery and its associated soft tissue defect is a serious complication that increases morbidity and mortality. In this article, we describe the reconstruction with the pectoralis major muscle flap in patients who have undergone open heart surgery and later developed a soft tissue defect in the median sternal incision line with the cause of infection, and our experience is reported.Material and Methods: A total of 7 patient underwent reconstruction of soft tissue defects of the chest wall due to infection developed in the sternal incision following open heart surgery with pectoralis major muscle flap between 2012 and 2017.Results: Early postoperative hematoma occurred in one patient and reoperated. Partial loss occurred in the skin graft placed on the flap in 1 patient and the defect was closed with partial thickness skin graft taken from the thigh. In other patients, there was no wound healing problem and full recovery was achieved.Conclusion: As a result; reconstruction of anterior chest wall soft tissue defect following open heart surgery with pectoralis muscle flap and adequate debridement is an effective and reliable method

Keywords

• Anterior chest wall defect, Pectoralis major muscle flap, Sternal soft tissue defect

Kaynakça

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