TRIPLE FLAP STERNAL WOUND CLOSURE TECHNIQUE IN DEEP MEDIASTINITIS IN ONE SESSION

Hakan Ağır, Bahadır Özkeskin, *Haluk Akbaş, **Salih Topçu, *Turan Berki

Kocaeli Ünivesitesi Tıp Fakültesi, Plastik ve Rekonstrüktif Cerrahi Ana Bilim Dalı, Kocaeli
*Kocaeli Ünivesitesi Tıp Fakültesi, Kalp Damar Cerrahisi Ana Bilim Dalı, Kocaeli
**Kocaeli Ünivesitesi Tıp Fakültesi, Göğüs Cerrahisi Ana Bilim Dalı, Kocaeli

In mediastinitis cases unresponsive to conventional management, bilateral pectoralis major (BPM) flap advancement can be inadequate for the sternal wound closure. In this study, triple flap closure technique was presented for the treatment of a deep and wide mediastinitis developed after coronary bypass in a case with hypertension and diabetus mellitus. Rectus abdominis muscle (RAM) transfer was successfully used beneath BPM musculocutaneous advancement flaps, in order to cover deep and inferior parts of the wound. In conclusion, in serious wounds, additional flap transfers can be frequently required and a RAM flap transfer is a good option for this purpose with its relatively simple surgical technique, close anatomical location and well-vascularised adequate bulk.

Keywords : Mediastinitis, pectoralis major, rectus abdominis

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