Combined vacuum-assisted closure treatment with laparoscopic mobilization of an omental flap and meshed skin grafts for reconstruction of infected sternotomy wounds: two cases [Vakum potpomognuto liječenje i laparoskopski mobilizacija velikog omentuma u liječenju teških infekcija rana prsne kosti: prikaz dva slučaja]

Veir, Zoran and Smuđ, Sanda and Bogdanić, Branko and Cvjetičanin, Bruno and Bagatin, Dinko and Dujmović, Anto and Duduković, Mladen and Ivrlač, Radojko and Bulić, Krešimir and Mijatović, Davor (2009) Combined vacuum-assisted closure treatment with laparoscopic mobilization of an omental flap and meshed skin grafts for reconstruction of infected sternotomy wounds: two cases [Vakum potpomognuto liječenje i laparoskopski mobilizacija velikog omentuma u liječenju teških infekcija rana prsne kosti: prikaz dva slučaja]. Collegium Antropologicum, 33 (4). pp. 1427-1430. ISSN 0350-6134

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Abstract

In cardiac surgery, poststernotomy wounds are life threatening complications, with mortality up to 50%. We described two patients, who underwent coronary artery bypass grafting and postoperatively developed a deep sternal wound infection. Reconstruction was combined with vacuum-assisted closure treatment, laparoscopic mobilization of an omental flap and split thicknes skin grafts. The omental flap is a well-vascularized local flap with a large surface area and has excellent immunologic and angiogenic properties. Both patients recovered completely. In our opinion, vacuum-assisted closure treatment and laparoscopic mobilization of great omentum is suitable option for treating deep sternal wounds.

Abstract in Croatian

U kardijalnoj kirurgiji nakon operativnog zahvata, infekcija rane može biti fatalna. Mortalitet doseže čak do 50%. Opisali smo dva bolesnika, koji su nakon ugradnje srčane premosnice razvili tešku infekciju rane prsne kosti. Liječenje je započeto vakum pumpom, zatim je korišten laparoskopski pristup za mobilizaciju velikog omentuma te je veliki omentum pokriven s režnjem kože dijelomične debljine. Veliki omentum je izvrsno vaskularizirano tkivo, velike površine s odličnim imunološkim svojstvima. Također omentum potiče rast novih krvnih žila. Oba bolesnika u potpunosti su se oporavila. Po našem mišljnju kombinacija vakum potpomognutog liječenja te mobilizacija omentuma laparoskopskom tehnikom, predstavlje dobar način liječenja za teže infekcije prsne kosti.

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