Abstract
Introduction Omental flap (OF) is a traditional surgical option to counteract severe postcardiotomy
mediastinal infection and to cover extensive sternal defects. We reviewed our experience
with omental flap transfer (OFT) in various clinical circumstances, in which omentoplasty
may be considered by cardiac surgeons.
Methods Twenty-one patients, who underwent OFT from January 2012 to December 2021, were studied.
The main indication was treatment of infected foreign material implants including
vascular grafts and ventricular assist devices or prevention of its infection (16
patients). In five patients, an OFT was used to cure mediastinitis following deep
sternal wound infection after median sternotomy.
Results All patients had a high surgical risk with 3 ± 1.9 previous sternotomies and a mean
Euro Score II of 55.0 ± 20.1. OF was successful in its prophylactic or therapeutic
purpose in all patients, no complications related to the operative procedure were
noted, that is, no early or late flap failure and no herniation of abdominal organs
occurred. In-hospital mortality was six patients as three patients each died from
multiple organ dysfunction syndrome and cerebral hemorrhage. All fifteen patients
discharged demonstrated rapid recovery, complete wound healing without fistula, and
no late gastrointestinal complications. The mean follow-up of 18 months was uneventful.
Conclusion OFT seems to be an excellent solution for extensive mediastinal and deep sternal
wound infections.
Keywords
mediastinitis - sternal wound infection - omentoplasty - omental flap transfer - sternal
wound infection
