Abstracts & commentary

Plastics

Chest wall reconstruction

Pectoralis muscle flap reconstruction of pediatric sternal wound infections

Zabel D, Eskra BD, Laddis D, Noorchashm N, Siewers R, Bentz ML. J Craniofac Surg. 2003;14:512–516.

Objective: Determine the incidence of poststernotomy wound infections requiring muscle flap repair and evaluate the experience with pectoralis myocutaneous flaps in a consecutive group of pediatric patients.

Design: Retrospective study.

Setting: Children’s Hospital of Pittsburgh, Pennsylvania, tertiary referral center.

Participants: One thousand two hundred consecutive pediatric patients undergoing

Deep sternal wound infection: a sternal-sparing technique with vacuum-assisted closure therapy

Gustafsson RI, Sjõgren J, Ingemansson R. Ann Thorac Surg. 2003;76:2048–2053.

Objective: Evaluate the use of vacuum-assisted closure in preparing infected sternotomy wounds for reclosure and refixation of the sternum.

Design: Retrospective review of a single institutional experience over a 3-year period.

Setting: Department of Cardiothoracic Surgery Heart and Lung Division, Lund University Hospital, Lund, Sweden.

Participants: All patients with signs and symptoms of deep sternal wound infections

Rectus abdominis myocutaneous flap after unsuccessful delayed sternal closure

Shibata T, Hattori K, Hirai H, Fujii H, Aoyama T, Seuhiro S. Ann Thorac Surg. 2003;76:956–958.

Objective: Evaluate the use of the rectus abdominis myocutaneous flap for treatment of unsuccessful delayed sternal closure in patients after open-heart surgery.

Design: Case series, retrospective.

Setting: Department of Cardiovascular Surgery, Osaka City University Medical School, Osaka, Japan.

Participants: Sternal edges could not be approximated in 7 of 523 patients undergoing open-heart surgery

Microvascular reconstructions of full-thickness oncological chest wall defects

Tukiainen E, Popov P, Asko-Seljavaara S. Ann Surg. 2003;238:794–802.

Objective: Evaluate the suitability of microvascular flaps for the reconstruction of extensive full-thickness defects of the chest wall.

Design: Retrospective review of a single institutional experience over a 13-year period.

Setting: Department of Plastic Surgery, Helsinski University Hospital, Helsinski Finland, a tertiary referral center.

Participants: Twenty-six patients with histopathological diagnosis of cancer underwent

Chest wall reconstruction using iliac bone allografts and muscle flaps

Garcia-Tutor E, Yeste L, Murilllo J, Aubá C, Sanjulian M, Torre W. Ann Plastic Surg. 2004;52(1):54–60.

Objective: To present the use of cryopreserved iliac bone allografts as an option to achieve stability for the reconstruction of full thickness defects after tumor resection of the chest wall.

Design: Case reports of 3 patients undergoing reconstruction of full-thickness chest wall defects for cancer.

Setting: Department of Plastic Surgery, Thoracic Surgery, Orthopedic Surgery. Clínica

Reviewer summary

Acquired defects of the chest wall after tumor resection, radiation therapy, trauma, and infection are the most common indications for chest wall reconstruction in the adult population. Often, the indications overlap, making cases more challenging.³ In pediatric patients, common indications include postoperative infections and congenital malformations. Sternal wound infections after midline sternotomy add significant morbidity and mortality to the cardiac patient population. The incidence of