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Chest Wall Recon after sternal dehisence of sternectomy
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Back Recon after spinal infection or dehisence
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Sacral Decub
Following criteria must be met prior to flap reconstruction:
Nutrition: albumin > 2.5 gm/dl Prealbumin: normal >16 mg/dl. In general patients with osteo and inflammatory processes do not have a normal prealbumin. (negative acute phase reactant). However, if they can show consistent elevation in prealbumin over 3 weeks, they can be considered candidates for reconstruction.
The patient must have Source control: Adequate debridement and staged reconstruction after several weeks of IV antibiotics.
Flap reconstruction may be scheduled after the debridement with the patient managed with a wound vac.
Control of any spasms or release of fixed contractures that may impair flap mobilization.
Bowel regimen well established and urinary control. If necessary, diversion prior to surgery.
Plan for postoperative disposition: pressure relieving surface obtained prior to debridement, medical management and rehabilitation plan.
The patient is to follow up with Dr. *** in outpatient clinic.
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