Papers of the Northeastern Society of Plastic Surgeons: PDF OnlyMuscle Flap Reconstruction of Pediatric Poststernotomy Wound InfectionsGrant, Robert T. MD*; Breitbart, Arnold S. MD*; Parnell, Vincent MD†Author Information *From the Divisions of Plastic and Reconstructive Surgery, North Shore University Hospital-NYU School of Medicine, Manhasset, NY †From the Divisions of Cardiothoracic Surgery, Department of Surgery, North Shore University Hospital-NYU School of Medicine, Manhasset, NY Annals of Plastic Surgery: April 1997 - Volume 38 - Issue 4 - p 365-370 Buy Abstract Sternal wound infections following pediatric open-heart procedures occur infrequently. Four of our last 600 consecutive pediatric open-heart median sternotomies (1991 to 1996) required muscle flap reconstruction for treatment of deeply infected sternotomy wounds. Risk factors included multiple sternotomies, previous superficial infection, and immunocompromised states. Two patients were closed with bilateral pectoralis muscle flaps. The 2 other patients were closed with vertical rectus abdominis muscle flaps; 1 including an attached skin paddle. While the pectoralis major muscle flap is the first flap of choice utilized in adult patients, in pediatric patients a different hierarchy of flap selection is often necessary. The chest wall often has multiple scars from previous procedures, limiting use of the pectoralis muscle. In small infants the pectoralis muscle can be thin and inadequate for large sternal defects. All patients achieved healed wounds. Muscle flap reconstruction of pediatric sternal wounds can be an effective one-stage treatment for deep sternal wound infections with sternal instability. © Williams & Wilkins 1997. All Rights Reserved.