Double-Pedicled Vertical Rectus Abdominis Myocutaneous Flap for Sternal Dehiscence Due to Deep Sternal Wound Infection: The Twelfth Intercostal Artery Perforator as an Additional Pedicle

Ryohei Ishiura; Kohei Mitsui; Kanako Danno; Kento Hosomi; Chihena Hansini Banda; Yasuhisa Urata; Mitsunaga Narushima

doi:10.3400/avd.cr.25-00024

Case Report

Double-Pedicled Vertical Rectus Abdominis Myocutaneous Flap for Sternal Dehiscence Due to Deep Sternal Wound Infection: The Twelfth Intercostal Artery Perforator as an Additional Pedicle

Ryohei Ishiura , Kohei Mitsui, Kanako Danno, Kento Hosomi, Chihena Hansini Banda, Yasuhisa Urata, Mitsunaga Narushima

Author information

Ryohei Ishiura Corresponding author
https://orcid.org/0000-0002-8900-0124
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan
Department of Cardiovascular Surgery, Mie Central Medical Center, Tsu, Mie, Japan
Kohei Mitsui
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan
Kanako Danno
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan
Kento Hosomi
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan
Chihena Hansini Banda
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan
Yasuhisa Urata
Department of Cardiovascular Surgery, Mie Central Medical Center, Tsu, Mie, Japan
Mitsunaga Narushima
Department of Plastic and Reconstructive Surgery, Mie University Hospital, Tsu, Mie, Japan

Keywords: VRAM, sternal dehiscence, deep sternal wound infection

JOURNAL OPEN ACCESS

2025 Volume 18 Issue 1 Article ID: cr.25-00024

DOI https://doi.org/10.3400/avd.cr.25-00024

Details

Abstract

A 50-year-old male with diabetes mellitus, who experienced recurrent sternal dehiscence secondary to a deep sternal wound infection, failed to respond to treatment with both pectoralis major muscle and greater omental flaps. Consequently, we performed a vertical rectus abdominis muscle flap in a double-pedicle fashion, utilizing the internal mammary artery and the 12th intercostal artery perforator. This intervention successfully addressed the condition. This novel technique offers an excellent therapeutic option for managing this life-threatening complication.

Corresponding author

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