Pectoralis major turnover versus advancement technique for sternal wound reconstruction
Hamid R Zahiri1, Kimberly Lumpkins, Shahrooz Kelishadi
1Division of General Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Background:
We compared the efficacy of pectoralis turnover versus advancement technique for sternal wound reconstruction.
Methods:
A retrospective chart review was performed, December 1989 to December 2010, to compare postoperative complication rates between pectoralis major turnover versus pectoralis major advancement reconstruction techniques. Complications included hematomas, wound infections, tissue necrosis, dehiscence, and need for reoperation. Pearson χ and logistic regression were used and significance was P < 0.05.
Results:
Sixty-seven patients received 91 tissue flaps. Eleven patients (16%) required reoperation due to complications, including recurrent wound infection, tissue necrosis, wound dehiscence, mediastinitis, and hematoma formation. Four patients (6%) were treated conservatively for minor complications. Overall, complication rates were significantly higher after pectoralis major advancement reconstruction (32.5% vs. 3.7%, P = 0.004).
Conclusions:
When feasible, pectoralis major turnover flap offers a superior reconstructive technique for complex sternal wounds, with diminished complications compared with the pectoralis advancement flap.
