Superior epigastric artery perforator flap for reconstruction of deep sternal wound infection
Case series published in Microsurgery (2021)
Abstract
BACKGROUND: The treatment of deep wound sternal infection requires loco-regional pedicled flaps, usually with muscular flaps. Perforator propeller flaps represent the ultimate progress in the history of reconstructive surgery. We report here our experience with the superior epigastric artery perforator (SEAP) flaps to repair sternal defect. PATIENTS AND METHODS: Six patients presenting deep sternal wounds infection were treated with SEAP propeller flap, between March 2015 and June 2017. The mean age was 71.5 (range 53-83) years. The mean length and width of the defect were 16.2 × 7 cm (ranging 8-20 × 4-10). An elliptical skin flap pedicled on the SEAP was harvested in the inframammary fold and rotated up to 90° to cover the defect. RESULTS: All SEAP flaps achieved a successful entire coverage of the defect. The mean size of the skin paddle of the flap was 20.2 × 7.3 cm (ranging 14-27 × 6-9). All flaps were able to provide a complete sternal wound cover. Venous congestion was present in five cases and adequately treated by leech therapy; necrosis was distal in one case, and interesting the entire superficial flap in two cases but with deep tissues remaining viable and able to cover the mediastinum: an infected flap required revision. Satisfyingly, at 2-years postoperative follow-up all-patients were alive with a successful mediastinal cover. CONCLUSIONS: The SEAP Perforator propeller flap is an alternative to muscle flaps to achieve treatment of deep and large sternal wound infection.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Series of 6 patients with deep sternal wound infections reconstructed with superior epigastric artery perforator propeller flaps. Five of six developed venous congestion successfully managed by leech therapy, achieving complete mediastinal coverage.
Por qué esto importa para la hirudoterapia
Este estudio reportó seis pacientes con infecciones profundas de la herida esternal reconstruidas con colgajos en hélice de perforantes de la arteria epigástrica superior (SEAP). Cinco de los seis pacientes desarrollaron congestión venosa, que fue tratada adecuadamente mediante terapia con sanguijuelas, y todos los pacientes lograron una cobertura mediastínica exitosa en el seguimiento a dos años. Para la ASH, esto es directamente relevante como una aplicación clínica moderna de la hirudoterapia para la congestión venosa de colgajos, una indicación bien establecida. Sin embargo, el objetivo principal del estudio es la técnica quirúrgica del colgajo; la terapia con sanguijuelas se reporta solo como una medida adyuvante exitosa sin detalles sobre la especie de sanguijuela, la duración, el número de sesiones ni complicaciones como infección. No se proporcionan datos controlados sobre la eficacia de la terapia con sanguijuelas.
Citación
Superior epigastric artery perforator flap for reconstruction of deep sternal wound infection.
Bertheuil N et al. · Microsurgery, 2021
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026