A case report of difficult sternal closure is described. Chest closure following cardiac
operation in critically ill patients can be a problem. Techniques have been described
so that sternal closure can be delayed until the patient is hemodynamically stable
and hemostasis has been achieved. However, in some instances, the sternal closure
can not be performed because of prolonged cardiopulmonary instability. We describe
the use of transpostion of an omentall flap with skin grafting in a 74-year-old patient
with aortic valve stenosis, poor pulmonary function, and a thoracic deformity. This
technique enabled incomplete sternal closure which maintained hemodynamic stability.
Delayed sternal closure - Chest deformity - Omental flap with skin grafting
