J reconstr Microsurg 2018; 34(05): 376-382
DOI: 10.1055/s-0038-1629918
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Sternal Reconstruction with the Omental Flap—Acute and Late Complications, Predictors of Mortality, and Quality of Life

J. Kolbenschlag
1  Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Tuebingen, Eberhard Karls University, Tuebingen, Germany
,
C. Hörner
2  Department of Internal Medicine, St. Elisabeth Hospital, Bochum, Germany
,
A. Sogorski
3  Department of Plastic Surgery, Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr University, Bochum, Germany
,
O. Goertz
4  Department of Plastic, Reconstructive and Esthetic Surgery, Hand Surgery, Martin-Luther-Hospital, Berlin, Germany
,
A. Ring
5  Department of Plastic, Reconstructive and Aesthetic Surgery, Hand Surgery, St. Rochus Hospital Castrop-Rauxel, Castrop-Rauxel, Germany
,
K. Harati
3  Department of Plastic Surgery, Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr University, Bochum, Germany
,
M. Lehnhardt
3  Department of Plastic Surgery, Hand Surgery, Burn Center, BG University Hospital Bergmannsheil, Ruhr University, Bochum, Germany
,
A. Daigeler
1  Department of Hand-, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Tuebingen, Eberhard Karls University, Tuebingen, Germany
› Author Affiliations
Further Information

Publication History

14 October 2017

07 December 2017

Publication Date:
06 April 2018 (online)

Abstract

Background The omental flap is a reliable flap for the coverage of sternal defects. However, little is known about the predictors of mortality and the long-term outcome in such patients.

Methods We, therefore, performed a retrospective study from 2002 to 2013, including all patients who underwent sternal reconstruction with the omental flap.

Results A total of 50 patients were identified and mean follow-up was 3.8 years. Patient data was collected from the charts and 14 patients were available for telephone interviews. The majority of patients suffered from deep sternal wound infections. There was no complete flap loss and an overall success rate was 96%. In-hospital mortality was 14% and overall survival over follow-up was 50%. Significant predictors of mortality were age > 65, American Society of Anesthesiologists' status, defect size, prolonged ventilation, and the need for tracheotomy. Postoperative quality of life was reduced compared with other cohorts, especially with regard to bodily function. Pain was also a major problem for most patients along with herniation.

Conclusion The omental flap is a safe option even in patients with severe comorbidities. However, based on the data in this study, we would recommend the omental flap as a reserve option rather than first-line treatment for sternal defects.

Note

None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.