Ernert, Carsten and Kielstein, Heike and Azatyan, Argine and Prantl, Lukas and Kehrer, Andreas (2024) Extended arc of rotation of Latissimus Dorsi Musculocutaneous Flap providing well-vascularized tissue for reconstruction of complete defects of the sternum: An anatomical study of flap pedicle modification. CLINICAL HEMORHEOLOGY AND MICROCIRCULATION, 86 (1-2). pp. 225-236. ISSN 1386-0291, 1875-8622
Full text not available from this repository. (Request a copy)Abstract
BACKGROUND: Deep sternal wound infections (DSWI) following cardiothoracic surgery represent a life quality endangering sequelae and may lead to sternal osteomyelitis. Radical debridement followed by Negative Pressure Wound Therapy (NPWT) may achieve infection control, provide angiogenesis, and improve respiratory function. When stable wound conditions have been established a sustainable plastic surgical flap reconstruction should be undertaken. OBJECTIVE: This study analyses a method to simplify defect coverage with a single Latissimus Dorsi Myocutaneous Flap (LDMF). METHODS: Preparation of 20 LDMF in ten fresh frozen cadavers was conducted. Surgical steps to increase pedicle length were evaluated. The common surgical preparation of LDMF was compared with additional transection of the Circumflex Scapular Artery (CSA). RESULTS: Alteration of the surgical preparation of LDMF by sacrificing the CSA may provide highly valuable wellvascularized muscle tissue above the sensitive area of the Xiphisternum. All defects could be completely reconstructed with a single LDMF. The gain in length of flap tissue in the inferior third of the sternum was 3.86 +/- 0.9 cm (range 2.2 to 8 cm). CONCLUSIONS: By sacrificing the CSA in harvesting the LDMF a promising gain in length, perfusion and volume may be achieved to cover big sternal defects with a single flap.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Latissimus dorsi myocutaneous flap; deep sternal wound infection; circumflex scapular artery; microsurgery; single flap reconstruction; sternal reconstruction; sternal defect |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Plastische-, Hand- und Wiederherstellungschirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 16 Oct 2025 07:14 |
| Last Modified: | 16 Oct 2025 07:14 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65284 |
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