Poster
# 107
Poster |
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6th Internet World Congress for Biomedical Sciences |
Mª Jesús Martínez González(1), Alejandro Nogueira(2), Olatz Alcelay(3)
(1)(2)(3)Hospital Central de Asturias - OVIEDO. Spain
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[Orthopedics & Traumatology] |
[Plastic Surgery] |
It´s amply recognized that muscular flaps are appropiate treatment for osteomielitis (2). In this case, colaboration between Tissue Bank and Plastic Surgery made possible this intervention with optimal result (1).
76 year-old, female, insulin-dependient, is operated of cardiac valvuloplasty by medial esternotomy. In the first days postoperatory she developed a wound infection ( Ps. Aeruginosa), and dehiscence.She´s taken to intenssive care unit. The tissues are debrided and sutures are partiality retired in successive days. When acute infection is controled it´s planned reconstruction. Now she presents an skin loss of the lower sternal third, bone loss in the two lower sternal thirds and condro-costal insertions loss of 3th and following with chest wall inestability.
Skin and rest of tissue are debrided. Cryopreserved costal allograft is tailored and fixed with 2 memory retention staples between 5th costal cartilages to stabilize the chest box. Left pectoralis major flap advancement based on toraco-acromial vessels and right hemi-turover pectoralis major based on internal mammary artery paraesternal perforators are tailored. (1). Dead space is obliterated with hemiturover flap,under costal allograft. Over this, advancement flap is situated and skin defect is closed primarily.
In the postoperatory she was presented skin loss that was debrided and covered with split thickness skin graft.
2 years later osteomielitys is resoluted, the patient presents chest wall stability and the allograft is in place. Upper extremities adduction is persistent.
Figures: Preop and post-op aspect.
It´s recognized that muscular flaps are the best surgical treatment in osteomielitis. In this case costal allograft is situated between two muscular flaps hightly vascularized to insure its survival and sterility. Further osteomielitis is resoluted by rich supply blood.
Chest wall inestability with sternal bone loss is reconstructed with costal allograft of Tissue Bank and muscular flaps (hemiturnover flap and pectoralis major flap advancement). Functional results are excellent and osteomielitis is resoluted.
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[Orthopedics & Traumatology] |
[Plastic Surgery] |
