Omentoplasty in deep sternal wound infection

The aim of this study was to evaluate retrospectively the results of reconstructing infected post-sternotomy incisions with pedicled omentoplasty.

Between March 2009 and December 2012, 15 females (37.5%) and 25 males (62.5%) with an average age of 63 y (range 51-72 y) who were suffering from deep sternal wound infection (DSWI) after coronary artery bypass grafting underwent reconstructive surgery. We evaluated their pre-operative characteristics and post-operative courses.

Thirty-four of the patients (85%) were found to have DSWI within 1 mo of their cardiac surgery. The mean operative time for the omental flap (OF) procedure was 90±16.8 min (range 70-135 min). There were three intra-operative complications (7.5%), and post-operative complications occurred in 10 patients (25%). No patient developed any sign of OF necrosis. The median lengths of the post-operative intensive care unit (ICU) and hospital stays were 4 d (range 1-6 d) and 7 d (range 5-14 d), respectively. At the time of discharge, all patients had normal cardiac and mental status.

We obtained satisfactory outcomes when treating the patients with DSWI by a single-stage OF transposition. On the basis of our experience, we recommend this procedure as an option for patients with DSWI, especially those who are not in a severe low cardiac output state or malnourished.