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The inframammary incision for median sternotomy in pediatrics
1Pediatric Heart Institute, St. Christopher's Hospital for Children, Philadelphia, PA 19133.
Insights
A new bilateral inframammary "butterfly" incision combined with median sternotomy improves cosmetic outcomes for pediatric patients. This approach offers excellent surgical exposure while minimizing visible scarring for improved patient body image.
Area of Science:
- Cardiovascular Surgery
- Pediatric Surgery
- Thoracic Surgery
Background:
- Median sternotomy is a standard surgical approach for cardiac and mediastinal procedures.
- A significant drawback of median sternotomy is the resulting unsightly scar, particularly concerning for pediatric and adolescent patients.
- Patient sensitivity regarding body appearance is a crucial factor in pediatric surgical outcomes.
Purpose of the Study:
- To evaluate the efficacy of a bilateral inframammary "butterfly" incision in conjunction with median sternotomy.
- To assess the cosmetic results and patient satisfaction with this alternative incision technique.
- To determine if this approach provides adequate surgical exposure for cardiac and mediastinal procedures.
Main Methods:
- A retrospective review of 31 patients undergoing cardiac or mediastinal procedures.
- Utilized a bilateral inframammary "butterfly" incision combined with median sternotomy.
- Assessed surgical exposure and cosmetic outcomes post-procedure.
Main Results:
- The bilateral inframammary "butterfly" incision provided excellent surgical exposure.
- Improved cosmetic results were observed compared to traditional median sternotomy scars.
- The technique was successfully applied in 31 pediatric and adolescent patients.
Conclusions:
- The bilateral inframammary "butterfly" incision is a viable alternative for improving cosmetic outcomes in pediatric cardiac and mediastinal surgery.
- This approach balances adequate surgical exposure with enhanced patient aesthetics.
- Minimizing visible scarring is important for improving body image and patient satisfaction in young patients.
Abstract:
Median sternotomy offers the ideal exposure for most cardiac and mediastinal procedures. One infrequently mentioned morbidity of the traditional median sternotomy is the unsightly scar, especially in pediatric and adolescent patients who are extremely sensitive about their body appearance. We report our experience using a bilateral inframammary "butterfly" incision on 31 patients in association with a median sternotomy to provide excellent exposure and an improved cosmetic result.