OBJECTIVE: Sternal @entity4421 after median sternotomy is associated with considerable morbidity and mortality. The use of muscle and omentum flaps has been proved as valid adjunct to combat these severe @entity281 . In this study we present our experience with a more radical approach. METHODS: Sternectomy consisted of the resection of the entire sternum, including the @entity6127 and the @entity2720 , and was followed by the repair of the defect with musculocutaneous flaps without any restabilization of the thoracic wall. Thirteen @entity1 received a vertical rectus abdominis musculocutaneous flap, 14 @entity1 received a pedicled latissimus dorsi musculocutaneous flap, and 12 @entity1 received a free latissimus dorsi musculocutaneous flap (total of 40 flaps in 39 @entity1 of 66 @entity1 who required surgical revision for sternal @entity4421 of 6078 total @entity1 with sternotomies). RESULTS: Two @entity1 died within 30 days after the operation (early mortality of 5.1%); however, they did not die of sternal infection, which was cured without any recurrence in all cases. Seventeen @entity1 (44%) required secondary, mostly minor operations for local complications. Despite some paradoxic chest movements, the @entity1 satisfaction rating was unanimously high at the long-term follow-up (0.4 to 8.5 years, median 2.3 years). The short- and long-term complication rates were similar in the three groups. CONCLUSION: We conclude that radical sternectomy and immediate musculocutaneous flap repair provided definitive control of sternal infection in even the most severe cases, thus reducing infection-related mortality. The trade-off was a substantial rate of local complications; however, these did not cause any relevant morbidity.

Radical sternectomy and primary musculocutaneous flap reconstruction to control sternal XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infections'] @entity4421 :: ('MESH:D010000', 'Disease') :: ['osteitis'] @entity2720 :: ('MESH:D007592', 'Disease') :: ['sternoclavicular joints'] @entity6127 :: ('MESH:D007569', 'Disease') :: ['costochondral arches']
@entity4421 :: (MESH:D010000,Disease) :: ['osteitis']
