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J Thorac Cardiovasc Surg 1996;112:631-636
© 1996 Mosby, Inc.

GENERAL THORACIC SURGERY

OBLITERATION OF EMPYEMA TRACT WITH DEEPITHELIALIZED UNIPEDICLE TRANSVERSE RECTUS ABDOMINIS MYOCUTANEOUS FLAP

Joseph M. Serletti, MD, Richard H. Feins, MD, Alexis J. Carras, MD, Joseph E. Losee, MD, David W. Johnstone, MD, H. Raul Herrera, MD, George L. Hicks, Jr., MD

From the Department of Surgery and the Divisions of Plastic Surgery and Cardiothoracic Surgery, University of Rochester, Rochester, N.Y.

Received for publication Dec. 4, 1995 Revisions requested Feb. 5, 1996; revisions received Feb. 27, 1996 Accepted for publication March 1, 1996 Address for reprints: Joseph M. Serletti, MD, PO Box 661, Strong Memorial Hospital, 601 Elmwood Ave., Rochester, NY 14642.

Abstract

Four patients with chronic empyema after pneumonectomy have undergone successful obliteration of the empyema tract with a deepithelialized transverse rectus abdominis myocutaneous flap. The deepithelialized skin island has provided sufficient bulk for tract obliteration. Rotation of the skin island into the long axis of the rectus muscle has added considerable length to this flap, allowing it to reach the apex of the thoracic cavity. A recurrent loculation developed 4 months after the obliteration procedure in one patient. This was successfully treated with open pleural drainage and a second Clagett procedure. Over a mean follow-up period of 35 months, all four patients are free of further infectious sequelae. Chest roentgenograms have confirmed eradication of the tracts in all four patients. (J THORAC CARDIOVASC SURG 1996;112:631-6)




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[Abstract] [Full Text] [PDF]


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