METHOD OF COMBINED PLASTY OF THE FRONT THORACIC WALL AT THE POST-STERNOTOMY MEDIASTINITIS Russian patent published in 2018 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to thoracic surgery and may be useful for the combined plasty of the anterior thoracic wall in post-sternotomy mediastinitis. Retained handle and the upper half of the body of the sternum are fixed with metal ligatures. Mobilize the flaps of greater pectoral muscles in the lateral direction to the level of the anterior axillary line from both sides. Mobilized edges of the muscles are fixed with nodal absorbable ligatures with each other and the periosteum of the sternum. From laparotomy access, a lock of a greater omentum is mobilized and moved to the mediastinum in the projection of the resected lower third of the sternum body. Lock of the greater omentum is fixed by absorbable ligatures to the remaining part of the ribs and periosteum of the sternum along the entire perimeter. Over the lock of the greater omentum and greater pectoral muscles lay coarse-meshed implant, which is fixed by separate nodal absorbable ligatures in the upper edge of the wound to the greater pectoral muscles both at the edge of the implant and at the sites of fixation of the muscles to the periosteum. In the lower edge of the wound, the coarse-meshed implant is fixed with separate nodal absorbable ligatures to the omentum flap, and also to the periosteum of the sternum and ribs.

EFFECT: method allows to eliminate the extended defect, to prevent the dislocation of the lock of the greater omentum into the abdominal cavity, to prevent the development of postoperative hernias, to prevent a relapse of mediastinitis.

1 cl, 4 ex