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Abstract
Sixty-six patients underwent various types of operative repair of a sternal wound
breakdown. A study was performed to compare the spirometry values before and after
these repairs to determine the long-term effect on respiratory function. Forty-four
patients were tested postoperatively; 27 had stable sternums, and seven required pectoralis-major
muscle flaps. Seventeen patients had unstable sternums; nine required pectoralis flaps,
and eight needed either rectus abdominis or omental flap repair of their sternal defects.
All patients had spirometry prior to their initial cardiac surgery and could act as
their own controls. In both the stable and unstable groups there was no significant
difference between preoperative and postoperative respiratory function measured after
6 months. However there was a statistically significant impairment of respiratory
function when omental or rectus muscle flap reconstruction was used compared with
sternal rewire or pectoralis muscle flap repair. This may have been due to the greater
disruption of chest-wall integrity with omental or rectus flap repairs. We conclude
that major sternal disruptions can be satisfactorily repaired with flaps of pectoral
or rectus muscle or omentum. Repair with omentum or rectus muscle was associated with
late impairment of respiratory function.
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Article info
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Copyright
© 1994 Published by Elsevier Inc.
