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首页> 外文期刊>Journal of plastic, reconstructive & aesthetic surgery: JPRAS >Use of the deltoid branch-based clavicular head of pectoralis major muscle flap in isolated sternoclavicular infections
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Use of the deltoid branch-based clavicular head of pectoralis major muscle flap in isolated sternoclavicular infections

机译：三角肌分支的胸大肌瓣的锁骨锁骨在孤立的胸锁骨感染中的应用

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Background The pectoralis major (PM) flap is the workhorse flap for acute, sub-acute and chronic sternoclavicular infections (SCIs). Attempts at using only the clavicular head of the pectoralis major muscle (CPM), based on internal mammary perforators or the thoracoacromial artery, have been reported. We describe the harvest of a deltoid branch-based flap (CPM-DTA) and examine its use in managing a series of isolated, acute and sub-acute sternoclavicular infections. Methods From 2007 to 2012, 28 subjects with SCI underwent PM flaps at our institution. Six were excluded for extensive chest wall involvement, and four were excluded from chronic osteomyelitis (5 months of infection or greater). Of the remaining 18 patients with isolated SCI, 12 underwent traditional PM flaps (Group-A), while six underwent CPM-DTA (Group-B). Features studied include age, gender, co-morbidities, culture, need for intra-operative extension of the sternoclavicular incision, postoperative complications, wound healing, time from infection onset to debridement, length of hospital stay, postoperative chest wall contour deformity and follow-up. Results Infections resolved and wounds healed in all patients following a single reconstructive procedure. Intra-operative need for extended incisions and postoperative ipsilateral anterior chest wall contour deformity are noted in all Group-A subjects but in no Group-B subjects. Conclusion In patients with isolated, acute and sub-acute SCI, the CPM-DTA flap achieves effective wound closure while avoiding large sternal incisions and the morbidity associated with standard PM muscle harvest. Harvesting the CPM-DTA flap preserves the sternocostal head of the pectoralis major muscle and its thoracoacromial pedicle. This preserves the muscle for future flap use if necessary.
机译：背景胸大肌（PM）皮瓣是用于急性，亚急性和慢性胸锁骨感染（SCI）的主力皮瓣。据报道，尝试仅使用基于内部乳腺穿孔器或胸膜顶动脉的胸大肌（CPM）的锁骨头。我们描述了基于三角肌分支皮瓣（CPM-DTA）的收获，并检查了其在处理一系列孤立，急性和亚急性胸锁骨感染中的用途。方法2007年至2012年，我院对28例SCI患者进行了PM皮瓣治疗。 6例因广泛的胸壁受累而被排除在外，而4例被排除在慢性骨髓炎（感染5个月或更长时间）之外。其余18例孤立性SCI患者中，有12例进行了传统的PM皮瓣（A组），而6例进行了CPM-DTA（B组）。研究的特征包括年龄，性别，合并症，文化，需要进行术中扩展锁骨切口，术后并发症，伤口愈合，从感染到清创的时间，住院时间，术后胸壁轮廓变形和随访。向上。结果所有患者均通过一次重建手术即可治愈感染并治愈伤口。在所有A组受试者中均注意到术中需要扩大切口和术后同侧前胸壁轮廓变形，而在B组受试者中均没有。结论对于孤立，急性和亚急性SCI患者，CPM-DTA皮瓣可实现有效的伤口闭合，同时避免了胸骨大切口和标准PM肌肉收获相关的发病。收集CPM-DTA皮瓣可保留胸大肌的胸肋头部及其胸顶椎弓根。这样可以保留肌肉，以备将来需要时使用。

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