Laparoscopic harvest and filling of an omental flap for infected mediastinal wound reconstruction : a case report Hidenori TAKAHARA 1 , Naoki NAGAYOSHI 1 , Takahiro TASHIRO 1 , Tadashi YOKOYAMA 1 1Department of Surgery, Ako City Hospital Keyword: 腹腔鏡下手術 , 大網充塡 , 縦隔炎 pp.761-765
Published Date 2012/12/15
DOI https://doi.org/10.11477/mf.4426100864
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 A 73-year-old man was suffering from an infected sternotomy dehiscence following coronary artery bypass grafting. Aggressive medical therapy, debridement of the infected wound and vacuum assisted closure (VAC) resolved purulent effusion. At this point, we decided to perform the reconstructive surgical procedures. We performed laparoscopic harvest of an omental flap and used it to fill the sternal defect through a small diaphragm incision while confirming its viability. The omental flap was fixed to the sternal wound and the skin was closed as usual. The postoperative course was uneventful and the patient was discharged on POD 15. Transposition of the greater omentum has traditionally required an open laparotomy with significant laparotomy-related morbidity. Laparoscopic surgery may be an effective alternative for the treatment of infected mediastinal wounds with decreasing the physiological stress after open heart surgery.

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