Sternal Reconstruction with the Omental Flap—Acute and Late Complications, Predictors of Mortality, and Quality of Life
| Autor: | M. Lehnhardt, Alexander Sogorski, Jonas Kolbenschlag, Andrej Ring, Kamran Harati, Ole Goertz, C. Hörner, Adrien Daigeler |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty medicine.medical_treatment 030230 surgery Omental flap Risk Assessment Surgical Flaps Cohort Studies 03 medical and health sciences 0302 clinical medicine Tracheotomy Complete flap loss Quality of life medicine Humans Surgical Wound Infection In patient Survival rate Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study Middle Aged Plastic Surgery Procedures Sternotomy Surgery Survival Rate Treatment Outcome 030220 oncology & carcinogenesis Quality of Life Female business Omentum Follow-Up Studies Cohort study |
| Zdroj: | Journal of Reconstructive Microsurgery. 34:376-382 |
| ISSN: | 1098-8947 0743-684X |
| DOI: | 10.1055/s-0038-1629918 |
| Popis: | Background The omental flap is a reliable flap for the coverage of sternal defects. However, little is known about the predictors of mortality and the long-term outcome in such patients. Methods We, therefore, performed a retrospective study from 2002 to 2013, including all patients who underwent sternal reconstruction with the omental flap. Results A total of 50 patients were identified and mean follow-up was 3.8 years. Patient data was collected from the charts and 14 patients were available for telephone interviews. The majority of patients suffered from deep sternal wound infections. There was no complete flap loss and an overall success rate was 96%. In-hospital mortality was 14% and overall survival over follow-up was 50%. Significant predictors of mortality were age > 65, American Society of Anesthesiologists' status, defect size, prolonged ventilation, and the need for tracheotomy. Postoperative quality of life was reduced compared with other cohorts, especially with regard to bodily function. Pain was also a major problem for most patients along with herniation. Conclusion The omental flap is a safe option even in patients with severe comorbidities. However, based on the data in this study, we would recommend the omental flap as a reserve option rather than first-line treatment for sternal defects. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|