Reconstruction of Post-Sternotomy Defects Using Pectoralis Major Flaps with or without Z-Plasty – A Case Series of Five Patients

Abstract

Deep sternal wound infections (DSWI) following cardiac surgery are rare but severe complications, associated with significant morbidity and prolonged recovery. Early detection and appropriate reconstruction using vascularized soft tissue are key to preventing mediastinitis and reducing mortality.

This case series highlights five patients who developed sternal wound dehiscence with or without pericardial exposure following median sternotomy. All were successfully managed using bilateral pectoralis major muscle flaps, and in three cases, local fasciocutaneous Zplasty flaps were added for inferior defect coverage. None required omental or free flaps. All patients healed well without major complications.