胸大肌带蒂肌瓣转移治疗心脏外科手术后胸骨感染37例  

Transplantation of pectoralis major pedicled flap in the treatment of 37 cases of sternal wound infection after cardiac surgery

作　　者：王宇 李红 文仁国 马瑞彦 肖颖彬 WANG Yu;LI Hong;WEN Ren-guo;MA Rui-yan;XIAO Ying-bin(Department of Cardiovascular Surgery,Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第二附属医院心血管外科,重庆400037

出　　处：《局解手术学杂志》2023年第11期945-947,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的 探讨胸大肌带蒂肌瓣转移治疗经胸骨正中切口心脏外科手术后胸骨感染的临床效果。方法 纳入我院37例行胸骨正中切口心脏外科手术后胸骨感染的患者,术中通过扩大创口,彻底清除感染的胸骨灶,充分游离胸大肌肌瓣,翻转填塞胸骨缺损处。观察患者术后切口愈合效果。结果 术后未出现其他并发症及死亡病例;30例患者切口愈合良好,7例患者切口愈合欠佳,经积极换药及对症处理后,切口愈合良好。随访1~6个月,患者未出现感染复发、红肿渗出、肌瓣坏死结痂。结论 采用胸大肌带蒂肌瓣转移治疗经胸骨正中切口心脏外科手术后胸骨感染能促进伤口愈合,减少再次感染及其他并发症的发生,临床效果满意。Objective To investigate the clinical outcome of pectoralis major pedicled flap transplantation in the treatment of sternal infection after cardiac surgery through median sternotomy.Methods A total of 37 patients with sternal infection after cardiac surgery through median sternotomy were enrolled in our hospital.During operation,the infected sternal lesion was completely removed by expanding the wound,the pectoralis major pedicled flap was fully freed and turned over to fill the sternal defect.The wound healing effect was observed.Results There was no other complications or death cases after operation.The wound healing was good in 30 patients and poor in 7 patients,whose wound healing was good after aggressive dressing change and symptomatic treatment.After 1 to 6 months of follow-up,there was no recurrence of infection,redness,swelling or exudation,or muscle valve necrosis or crusting.Conclusion The pectoralis major pedicled flap transplantation in the treatment of sternal infection after cardiac surgery through median sternotomy can promote wound healing,reduce the occurrence of re-infection and other complications,with satisfactory clinical outcome.

关 键 词：心脏外科手术 经胸骨正中切口 胸骨感染 胸大肌带蒂肌瓣 皮瓣转移 

分 类 号：R655.1[医药卫生—外科学]