RESUMEN
We report a comorbid patient after redo Frozen Elephant Trunk procedure followed by recurrent infection of thoracic aortic prosthesis, deep sternal wound infection and extensive soft tissue defect. Closure with skin-muscle thoracodorsal flap and graft-sparing technique with omentoplasty is an alternative to total graft replacement for thoracic aortic graft infection in comorbid patients with concomitant extensive defect of the chest wall or recurrent infection in early postoperative period.
Asunto(s)
Aorta Torácica/cirugía , Implantación de Prótesis Vascular , Infecciones Relacionadas con Prótesis , Infecciones de los Tejidos Blandos/cirugía , Infección de la Herida Quirúrgica , Prótesis Vascular/efectos adversos , Implantación de Prótesis Vascular/efectos adversos , Humanos , Epiplón/trasplante , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/cirugía , Reoperación , Esternón/cirugía , Colgajos Quirúrgicos , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/cirugía , Pared Torácica/cirugía , Resultado del TratamientoRESUMEN
Among all thermal burn injuries, electrical burns are the most unpredictable and are characterized by the damage of depressing and functionally important anatomical structures, as well as an extensive volume of tissue damage. The tactics of treating such post-burn defects require always an individual and non-standard approach. In this article, a clinical example of the plastic closure of a neck defect is presented, as a result of a high-voltage electric burn received, with counter skin-muscular flaps based on m. platysma. Considering the major role of the lymphatic system in microcirculation, in the pathogenesis of inflammatory processes and the immune response of the body, during the planning of the operation anatomical features of the lymphatic vessels of the anterior surface of the neck were studied. The result of the operation was a primary, full-fledged closure of the defect with two opposing cutaneous muscle flaps with unilateral lymph node preservation as well as a full functional restoration of the neck motion. KEY WORDS: Electrical burns, Flaps lymph flow, Lymphatic system, Lymph nodes, Neck defect, Nonstandard clinical situations, Reconstruction.