[Reconstruction of infected median sternotomy wound dehiscence after coronary artery revascularization].

OBJECTIVE: To introduce the experience about the reconstruction of median sternotomy wound dehiscence. METHODS: From February 2002 to October 2004, 10 patients with median sternotomy wound dehiscence due to coronary artery revascularization were treated. There were 7 males and 3 females, aging from 68 to 76 years. The sizes of defects ranged from 3 cm x 5 cm to 5 cm x 15 cm. After debridement of necrotic soft tissue, sternum and rib, infected median sternotomy wound was reconstructed with rectus abdominis myocutaneous flap, pectoralis major myocutaneous flap and latissimus dorsi flap or single muscle flap. The sizes of flaps ranged from 3 cm x 5 cm to 5 cm x 16 cm. RESULTS: All patients were followed up from 3 to 11 months with an average of 6 months. All the patients achieved healing by first intention with normal respiration and normal function of upper limbs. The wound of donor site healed well. No abdominal hernia and other complications occurred. The wound of donor site healed well. The results were satisfactory. CONCLUSION: According to different stages of the disease and different conditions of an operation, the surgical management should vary with each individual.