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Long-Term Follow-up and Outcomes after Sternal Plating with Local Flap Reconstruction
Rebecca Knackstedt MD, PhD; Daniel P. Raymond MD; Edward Soltesz MD; Brian Gastman MD
Cleveland Clinic
2019-01-17
Presenter: Rebecca Knackstedt
Affidavit:
I confirm
Director Name: Steven Bernard
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: General Reconstruction
Introduction
When plating is utilized for sternal stabilization, there is often a soft tissue deficit. While there are reports on the outcomes of local flaps for sternal wounds without plating, there is no data on the long-term outcomes for patients undergoing sternal plating with flap reconstruction. The goal of this study is to report on our experience at a tertiary care center providing soft tissue coverage with flaps after sternal plating.
Materials and Methods
A retrospective chart review was conducted for all patients who underwent sternal plating with plastic surgery reconstruction by the senior author from 2010 to 2013. Charts were reviewed for indication for surgery, type of reconstruction and acute and chronic outcomes.
Results
20 patients fit inclusion criteria with an average age of 62.6. The most frequent indication for plating and flap reconstruction was non-union post CABG. 3 patients had a history of trauma leading to sternal instability or non-union. 12 patients had a unilateral flap and 8 had a bilateral flap. 2 patients had post-operative infections requiring intravenous antibiotics. 4 patients required re-operation with indications including sternal non-union (2, 9 and 16 months later), exposure of plating (1, 3 months later) and hematoma (1). The average follow-up was 864 days (range 5-2138 days).
Conclusion
We report on our long-term outcomes in patients with sternal plating necessitating flap coverage. We demonstrate that the pectoralis muscle is an excellent option for sternal coverage after plating with a low complication rate and low rate of re-operation.
