122PREDICTORS OF COMPLICATIONS AFTER PECTORALIS MAJOR TRANSPOSITION FOR STERNAL DEHISCENCE

• Published in: Interactive cardiovascular and thoracic surgery Vol. 19; no. suppl_1; pp. S37 - S38
• Main Authors: Molenkamp, S., Waterbolk, T.W., Mariani, M.A., Werker, P.M.N.
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2014
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivu276.122

Objectives: Mediastinitis and sternum dehiscence are serious complications following open heart surgery, causing an increase in mortality, hospital stay and utilisation of healthcare resources. The defect that remains after sternal wound debridement frequently necessitates reconstruction, for which pectoralis major transposition currently is the preferred method. In this study the postoperative outcome and individual characteristics of patients undergoing pectoralis major transposition were analysed in order to identify predictors of postoperative complications. Methods: A retrospective chart review was conducted, covering a 7-year time-period, focusing on patient and operation characteristics. All patients with a sternum dehiscence who underwent pectoralis major transposition were included. All postoperative wound complications were listed and graded according to the Clavien-Dindo classification of surgical complications. Complications were further divided in major and minor. Mortality was defined as death during hospital stay or within 30 days after sternal wound repair. Results: In total, 77 patients underwent a pectoralis major transposition repair of the sternum. Thirty-eight patients developed a surgical-site complication, of which 21 were defined as major wound complications. Mortality was 9%. Further analyses of our data showed that smoking and prolonged operative time were predictors of surgical-site complications. Women were more likely to develop wound re-dehiscence. Patients in whom the humeral insertion of the pectoralis major flap was divided experienced more postoperative bleeding needing reoperation. Conclusion: Female sex, smoking, detachment of the humeral insertion and operation time are independent predictors of complications following pectoralis major transposition for reconstruction of sternum dehiscence.