Laparoscopic mobilization of an omental flap for reconstruction of an infected sternotomy wound.

Abstract

The omentum is used for reconstruction of intra- and extra-abdominal wounds because of its high vascularity and immunological properties. It is used most often in patients in whom sternal wound infection develops after coronary artery bypass grafting. The major drawback of using the omentum is the necessity of performing a laparotomy to dissect and mobilize it to the thorax. The authors report their experience with an 81-year-old man, on whom they performed laparoscopic dissection and mobilization of the omentum, and transfer of the omentum based on its blood supply from the left gastroepiploic artery to reconstruct an infected sternal wound. The current literature is reviewed as well. The authors conclude that obtaining an omental flap via a laparoscopic approach is feasible and safe. It should be considered whenever an omental flap is needed outside the abdominal cavity. This approach mandates close collaboration between the plastic and the laparoscopic surgeons.