The coverage of wide and infected sternal defect with bilateral pectoralis muscle flaps

Poststernotomy mediastinitis is a highly dangerous complication following median sternotomy. Such wounds are debrided aggressively of necrotic and foreign materials with subsequent flap reconstruction. The patient, diagnosed with sternal defect which was infected, was examined with exposed bone and wires and not healing for five months. Operative debridement of infected bone and soft tissue was performed, including removal of sternal wires and other foreign bodies and then definitive coverage of the defect was made by bilateral pectoralis major muscle flaps. There were no complications in postoperative one year follow-up period and the patient has been leading normal social life while not having any respiratory problems except severe exercise. Using bilateral pectoral flaps for reconstruction of dead-spaces following debridement for patients having wide sternal defects is an appropriate and effective method.

Bilateral pektoral kas flebi ile geniþ ve enfekte sternum defektinin örtümü

Median sternotomi sonrasý geliþen mediastinit, oldukça tehlikeli bir komplikasyondur. Bu tür yaralarda nekrotik dokularýn debridmaný ve yabancý cisimlerin uzaklaþtýrýlmasý sonrasý uygun fleplerle rekonstrüksiyon gerekmektedir. Koroner bypass sonrasý 5 aydýr iyileþmeyen, enfekte, kemik ve tellerin açýkta olduðu sternum defekti ile baþvuran hastaya debridman, enfekte ve nekrotik kemiklerin ve tellerin çýkarýlmasý sonrasý bilateral pektoral fleple onarým uygulandý. Hastanýn defektinin sorunsuz iyileþtiði gözlendi. Bir yýldýr takip edilen hasta normal sosyal yaþantýsýný sürdürmekte ve aðýr egzersizler dýþýnda solunum sýkýntýsý yaþamamaktadýr. Geniþ, enfekte sternum defekti olan hastalarda debridman sonrasý ölü boþluðu da kapatacak þekilde bilateral pektoral fleple rekonstrüksiyon uygun, kolay uygulanabilir, etkili bir yöntemdir.