Few studies have reported re-sternotomy after an omental flap procedure.
We describe the case of a 78-year-old man who received re-sternotomy
after omental flap procedure for deep sternal wound infection and
successfully underwent coronary artery bypass grafting. Although
preoperative computed tomography showed funnel chest and limited space
between the sternum and omentum, re-sternotomy was performed safely
using circular electric sternum saw under partial cardiopulmonary
bypass. Because the omentum functioned as cushioning material between
the sternum and mediastinal organs, no injuries of the mediastinal
organs occurred. An ultrasonic scalpel effectively dissected between the
omentum and mediastinal organs, especially above the ascending aorta.
The targeted coronary arteries were easily detected. The patient
experienced no major cardiac or infectious events for three months. An
ultrasonic scalpel is recommended for dissecting between the omentum and
mediastinal organs.