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General session III
Moderated by Takehisa Iwai: Muscular Flap Treatment for Intractable Ulcer with Artificial Vessel Exposure After a Surgery for Thoracic Aortic Aneurysm
Author(s) -
Yamauchi T,
Kiyokawa K,
Tai Y,
Inoue Y,
Kizuka Y.
Publication year - 2005
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2005.130116j.x
Subject(s) - medicine , mediastinitis , surgery , mediastinum , lesion , cephalic vein , aneurysm , aortic arch , radiology , aorta , vein
Aim: To heal an exposed artificial vessel due to mediastinitis after the replacement of thoracic aortic aneurysm. Methods: The exposed vessel is washed thoroughly, wrapped in a muscular flap, and a free skin graft is grafted over it to close. Results: An 81‐year‐old male repeatedly had mediastinum after the replacement of aneurysm, and it was not cured with muscular fillings, and a rubor on the chest developed to a subcutaneous hematoma. The lesion was closed with a patch on the artificial vessel, the mediastinal abscess was washed, and the opening was closed by using latissimus dorsi muscular flap and split‐thickness skin graft. No recurrence has occurred for 3 years. A 69‐year‐old male developed mediastinitis after the replacement of thoracic arch aortic aneurysm, and the wound reopened and the vessel exposed. Because conservative treatment did not help, pectoralis major muscular flaps with the perforating branches of the internal thoracic artery and vein as the pedicle were elevated from the both sides, filled the mediastinal space and a split‐thickness skin graft was grafted. No recurrence has occurred for one year. Conclusions: Artificial vessels that developed infections are usually removed. However, we had good results by washing the lesion and wrapping it with muscular flap. By considering the size of surgical invasion and high death rate associated with the re‐replacement of artificial vessel or the opening of omentum, utilization of muscular flap should be considered as the first choice treatment.