Omental transposition flap for sternal wound reconstruction in diabetic patients

Amy Stump, Mazen Bedri, Nelson H. Goldberg, Sheri Slezak, Ronald P. Silverman

Research output: Contribution to journalArticle

Abstract

In 2004, we published our 12-year experience with tissue transfer for deep sternal wound infection after median sternotomy, finding increased rates of reoperation for diabetic patients. Therefore, we decided to alter our treatment approach to diabetic patients to include sternal debridement followed by omental transposition. Eleven diabetic patients underwent omental transposition by our division during the study period. Hospital records were retrospectively reviewed to determine outcomes and complications. We found that diabetic patients treated after implementation of the new treatment approach were 5.4 times less likely to require reoperation for sternal wound management than were patients in the previous series, most of whom had been treated with pectoralis muscle flaps (95% confidence interval, 0.5-50.5). By altering our treatment approach to use omental transposition as the initial surgical therapy, we were able to demonstrate a trend toward decreased need for flap revision in diabetic patients.

Original languageEnglish (US)
Pages (from-to)206-210
Number of pages5
JournalAnnals of Plastic Surgery
Volume65
Issue number2
DOIs
StatePublished - Aug 2010
Externally publishedYes

Fingerprint

Wounds and Injuries
Reoperation
Pectoralis Muscles
Sternotomy
Hospital Records
Debridement
Wound Infection
Therapeutics
Confidence Intervals

Keywords

  • mediastinitis
  • omental flap
  • omental transposition
  • omentoplasty
  • sternal wound infection
  • sternal wound reconstruction
  • tissue transfer

ASJC Scopus subject areas

  • Surgery

Cite this

Omental transposition flap for sternal wound reconstruction in diabetic patients. / Stump, Amy; Bedri, Mazen; Goldberg, Nelson H.; Slezak, Sheri; Silverman, Ronald P.

In: Annals of Plastic Surgery, Vol. 65, No. 2, 08.2010, p. 206-210.

Research output: Contribution to journalArticle

Stump, Amy ; Bedri, Mazen ; Goldberg, Nelson H. ; Slezak, Sheri ; Silverman, Ronald P. / Omental transposition flap for sternal wound reconstruction in diabetic patients. In: Annals of Plastic Surgery. 2010 ; Vol. 65, No. 2. pp. 206-210.
@article{8f674aa6a2cd40359acbeb664dd87820,
title = "Omental transposition flap for sternal wound reconstruction in diabetic patients",
abstract = "In 2004, we published our 12-year experience with tissue transfer for deep sternal wound infection after median sternotomy, finding increased rates of reoperation for diabetic patients. Therefore, we decided to alter our treatment approach to diabetic patients to include sternal debridement followed by omental transposition. Eleven diabetic patients underwent omental transposition by our division during the study period. Hospital records were retrospectively reviewed to determine outcomes and complications. We found that diabetic patients treated after implementation of the new treatment approach were 5.4 times less likely to require reoperation for sternal wound management than were patients in the previous series, most of whom had been treated with pectoralis muscle flaps (95{\%} confidence interval, 0.5-50.5). By altering our treatment approach to use omental transposition as the initial surgical therapy, we were able to demonstrate a trend toward decreased need for flap revision in diabetic patients.",
keywords = "mediastinitis, omental flap, omental transposition, omentoplasty, sternal wound infection, sternal wound reconstruction, tissue transfer",
author = "Amy Stump and Mazen Bedri and Goldberg, {Nelson H.} and Sheri Slezak and Silverman, {Ronald P.}",
year = "2010",
month = "8",
doi = "10.1097/SAP.0b013e3181c9c31a",
language = "English (US)",
volume = "65",
pages = "206--210",
journal = "Annals of Plastic Surgery",
issn = "0148-7043",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Omental transposition flap for sternal wound reconstruction in diabetic patients

AU - Stump, Amy

AU - Bedri, Mazen

AU - Goldberg, Nelson H.

AU - Slezak, Sheri

AU - Silverman, Ronald P.

PY - 2010/8

Y1 - 2010/8

N2 - In 2004, we published our 12-year experience with tissue transfer for deep sternal wound infection after median sternotomy, finding increased rates of reoperation for diabetic patients. Therefore, we decided to alter our treatment approach to diabetic patients to include sternal debridement followed by omental transposition. Eleven diabetic patients underwent omental transposition by our division during the study period. Hospital records were retrospectively reviewed to determine outcomes and complications. We found that diabetic patients treated after implementation of the new treatment approach were 5.4 times less likely to require reoperation for sternal wound management than were patients in the previous series, most of whom had been treated with pectoralis muscle flaps (95% confidence interval, 0.5-50.5). By altering our treatment approach to use omental transposition as the initial surgical therapy, we were able to demonstrate a trend toward decreased need for flap revision in diabetic patients.

AB - In 2004, we published our 12-year experience with tissue transfer for deep sternal wound infection after median sternotomy, finding increased rates of reoperation for diabetic patients. Therefore, we decided to alter our treatment approach to diabetic patients to include sternal debridement followed by omental transposition. Eleven diabetic patients underwent omental transposition by our division during the study period. Hospital records were retrospectively reviewed to determine outcomes and complications. We found that diabetic patients treated after implementation of the new treatment approach were 5.4 times less likely to require reoperation for sternal wound management than were patients in the previous series, most of whom had been treated with pectoralis muscle flaps (95% confidence interval, 0.5-50.5). By altering our treatment approach to use omental transposition as the initial surgical therapy, we were able to demonstrate a trend toward decreased need for flap revision in diabetic patients.

KW - mediastinitis

KW - omental flap

KW - omental transposition

KW - omentoplasty

KW - sternal wound infection

KW - sternal wound reconstruction

KW - tissue transfer

UR - http://www.scopus.com/inward/record.url?scp=77955228102&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77955228102&partnerID=8YFLogxK

U2 - 10.1097/SAP.0b013e3181c9c31a

DO - 10.1097/SAP.0b013e3181c9c31a

M3 - Article

C2 - 20606588

AN - SCOPUS:77955228102

VL - 65

SP - 206

EP - 210

JO - Annals of Plastic Surgery

JF - Annals of Plastic Surgery

SN - 0148-7043

IS - 2

ER -