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Smolle-Juettner, FM; Pierer, G; Schwarzl, F; Pinter, H; Ratzenhofer, B; Prause, G; Friehs, G.
Life-saving muscle flaps in tracheobronchial dehiscence following resection or trauma.
Eur J Cardiothorac Surg. 1997; 12(3):351-355 [OPEN ACCESS]
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Authors Med Uni Graz:
Pinter Hans
Prause Gerhard
Ratzenhofer-Komenda Beatrice
Schwarzl Franz
Smolle-Juettner Freyja-Maria
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Abstract:
In the presence of acute inflammation and necrosis of the wall, tracheo-bronchial defects are difficult to manage. The absence of adequate vascularization and the contaminated area prevent successful direct re-suturing. In order to restore a sufficient blood supply we used a pedicled latissimus dorsi or a pectoralis major flap that was entered into the thorax after a 10-cm resection of the second rib. A portion of the muscle was fitted into the tracheo/bronchial defect by reinforced sutures. The remaining muscle was sutured to the tissue surrounding the defect. This method was applied in various septic conditions: Bronchial defects; complete dehiscence of the right (n = 6) or left (n = 1) main bronchus at the carinal level following resection for lung cancer (n = 4) or for tuberculous (n = 2) on nontuberculous pleuropneumonia (n = 1). Tracheal defects; (1) destruction of one third of the tracheal circumference involving the cricoid down to the fourth ring following tracheotomy in presence of a septic sternum after intrathoracic goiter and Bechterew's disease; (2) 30% dehiscence of the anastomosis and septic sternum following tracheal resection; (3) Mediastinitis involving tracheal and esophageal wall following a 7 cm long iatrogenous laceration of the intrathoracic trachea. In one case the latissimus dorsi developed venous stasis on day 2 and was replaced by the pectoralis major muscle which showed uneventful healing. In all other patients the muscle flap resulted in an uneventful closure of the defect and recovery. Large, well vascularized, pedicled muscle flaps ensure a safe closure of tracheo-bronchial defects or dehiscences even in presence of gross necrosis and sepsis.
Find related publications in this database (using NLM MeSH Indexing)
Aged -
Anastomosis, Surgical - adverse effects
Bronchi - surgery
Female -
Follow-Up Studies -
Humans -
Length of Stay -
Male -
Middle Aged -
Necrosis -
Pneumonectomy - adverse effects
Sepsis - etiology
Sepsis - surgery
Surgical Flaps -
Surgical Wound Dehiscence - etiology
Surgical Wound Dehiscence - pathology
Surgical Wound Dehiscence - surgery
Thoracostomy -
Trachea - injuries
Trachea - surgery
Wound Healing -

Find related publications in this database (Keywords)
bronchial defect
tracheal defect
sepsis
closure
muscle-flap
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