Objective: To explore a surgical method for chronic osteomyelitis of sternum after thoracotomy.
Methods: From January 2006 to February 2009, 11 cases of chronic osteomyelitis after thoracotomy (2 cases of coronary bypass, 6 cases of mitral valve replacement, and 3 cases of ventricular defect repair) were admitted. Of them, there were 6 males and 5 females, aged from 6 to 62 years (median 34 years), including 6 cases of simple osteomyelitis of sternum, 2 cases of osteomyelitis of sternum with suppurative infection of mediastinum, and 3 cases osteomyelitis of sternum with costal chondritis. Necrotic sternum were excised and defect was from 4 cm x 3 cm to 7 cm x 4 cm. Greater pectoral muscle flap was designed from 8 cm x 5 cm to 10 cm x 6 cm on one side and was transferred to defect. Negative drainage and sensitive antibiotics were administered after operation.
Results: Healing by first intention was achieved in 10 patients except 1 patient who had a few discharge at the drainage outlet and whose incision healed 1 week later. The follow up was from 3 to 10 months with an average of 6 months. The formed scars were flat with soft texture in 8 patients and moderately hypertrophy in 3 patients. The wounds healed without pain, relapse or abnormal function of donor upper limb.
Conclusion: Transplantation of greater pectoral muscle flap is an effective way to repair chronic osteomyelitis of sternum after thoracotomy.
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