Functional results of muscle flap closure for sternal infection

The morbidity and mortality of infection after median sternotomy have been substantially reduced with the advent of treatment by wide sternal resection and muscle flap closure. A study was performed comparing the cardiorespiratory function of 13 such patients before and after operation as well as with a control group of 15 patients who underwent similar procedures without complication. The groups were comparable in preoperative pulmonary function, though more patients in the study group had evidence of chronic lung disease. Patients were studied 2 to 39 months after the original procedure. Late postoperative pulmonary function test results, exercise tolerance, and oxygen uptake were not significantly different between the groups, and pulmonary function test results were unchanged in those patients who were tested preoperatively. We conclude that muscle flap reconstruction for sternal infection can be expected to give good long-term functional results. Exercise tolerance and pulmonary function may not differ from a control group of cardiac surgical patients, despite the altered composition of the chest wall. Patients with chronic lung disease may be more prone to have this complication.