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Omentum Flap versus Pectoralis Major Flap in the Treatment of Mediastinitis

López-Monjardin, Homero M.D.; de-la-Peña-Salcedo, Abel M.D.; Mendoza-Muñoz, Mario M.D.; López-Yáñez-de-la-Peña, Arturo M.D.; Palacio-López, Edgardo M.D.; López-García, Alejandro M.D.

Plastic and Reconstructive Surgery: May 1998 - Volume 101 - Issue 6 - p 1481–1485
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The outcome of mediastinal reconstruction during the past 10 years at the “Instituto Nacional de Cardiología Ignacio Chávez” (INCIC), Mexico City was compared. A total of 7136 patients were submitted to open heart surgery. Eighty-two patients (1.15 percent) developed mediastinitis, and 33 patients (0.46 percent) developed sternal osteomyelitis. Only patients who developed mediastinitis with sternal osteomyelitis were included in the study. Reconstruction was performed either with a major omentum flap (12 patients) or a pectoralis major flap (21 patients). The sepsis-related mortality rate was higher in the pectoralis group (28.6 percent) than in the omentum group (0 percent) (p < 0.05). All of the postoperative deaths of the pectoralis group were caused by septic shock; in the omentum group, there were no such deaths. It is concluded that mediastinal reconstruction using the omentum flap in patients with mediastinitis secondary to open heart surgery is associated with fewer septic complications than using the pectoralis major flap. (Plast. Reconstr. Surg. 101: 1481, 1998.)

Mexico City, Mexico

Homero López-Monjardin M.D.

Durango 33, 3er piso, Dep. 32

Colonia Roma

México D. F. 06700

From the Instituto de Cirugía Plástica and the Instituto Nacional de Cardiología Ignacio Chávez. Received for publication November 20, 1996; revised June 2, 1997.

©1998American Society of Plastic Surgeons