Modified pectoralis major flap repair of sternal necrosis after median sternotomy

Median sternotomy is complicated by sternal dehiscence in 1-5% of cases [Belcher 1990]. Rewiring of the dehisced sternum can be done in most instances if the sternal margins are viable. The dehisced unstable sternum can be stabilized using tissue transfer if viable sternum is absent. This is usually performed by reconstructive surgeons using either pectoralis major flap [Pairolero 1991], omentum [ Weinzwerg 1995] or prosthetic material [Deschamps 1999]. We describe a simple method of repair using a modified bilateral pectoralis major flap with good results.