METHOD FOR ANTERIOR THORACIC WALL REPAIR IN STERNUM MALFUNCTION FOLLOWING STERNOTOMY

摘要

FIELD: medicine.SUBSTANCE: mobilising a strand of greater omentum is preceded by the intraoperative separation of edges of greater pectoral muscles circumferentially in the lateral direction to reach normally supplied tissues and intercostal muscles. The strand of greater omentum is mobilised and fixed by absorbable ligatures to a preserved portion of ribs and sternum along the entire perimeter. A large-mesh prosthesis is laid over the strand of greater omentum and overlaps the ribs from both sides under the prepared greater pectoral muscles. The large-mesh prosthesis is fixed by single interrupted absorbable ligatures to the intercostal muscles. The greater pectoral muscles are laid over the borders of the large-mesh prosthesis circumferentially and fixed thereto by another line of the interrupted sutures at 3 cm in the medial direction from the previous suture.EFFECT: method enables reducing the episodes of sternomediastinitis, eliminating a residual cavity in the anterior mediastinum, providing higher strength of the thoracic wall frame, avoiding postoperative hernias, and improving the patient's quality of life.1 dwg, 1 ex