Case ReportOpen Access

Vacuum Assisted Closure in the Management of Exposed Hardware for Skeletal Fixation: A Challenging Case

Volume 3 - Issue 4

**Alessio Baccarani*¹, Beatrice Aramini², Uliano Morandi² and Giorgio De Santis¹**

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- ¹Division of Plastic Surgery, University of Modena and Reggio Emilia, Italy
- ²Division of Thoracic Surgery, University of Modena and Reggio Emilia, Italy
*Corresponding author: Alessio Baccarani, MD FACs Associate Professor of Surgery Modena University Hospital, Italy

Received: March 21, 2018; Published: April 06, 2018

DOI: 10.26717/BJSTR.2018.03.000921

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Abstract

Pectus excavatum is a depression of the sternum and of costal cartilages, with reduction in the anteroposterior diameter of the thorax. It is the most common chest wall deformity requiring surgical correction. As described into the literature by many authors [1], metal supports for internal fixation to stabilize the sternum in the new corrected position are commonly used with an open approach. This sternochondroplasty procedure is performed under general anesthesia. The patient is placed in supine position with arms along the body. The skin incision is clamshell-like. Topographical landmarks for incision are the nipple in men and the inframammary fold in women. The ostheocartilaginous plane is exposed through the bilateral division of the sternal and rib insertions of the pectoralis major and the rectus abdominis muscles. The entire soft tissue plane (subcutaneous, skin and muscles) is mobilized and elevated en-block to avoid fluid collection and seroma formation in the early postoperative period.

Abbreviations: ICU : Intensive Care Unit; VAC : Vacuum Assisted Closure Therapy; WI : Welch Index