{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:19:45Z","timestamp":1777497585777,"version":"3.51.4"},"reference-count":67,"publisher":"SAGE Publications","issue":"1-2","license":[{"start":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T00:00:00Z","timestamp":1694822400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Hemorheology and Microcirculation"],"published-print":{"date-parts":[[2024,2,22]]},"abstract":"<jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Deep sternal wound infections (DSWI) following cardiothoracic surgery represent a life quality endangering sequelae and may lead to sternal osteomyelitis. Radical debridement followed by Negative Pressure Wound Therapy (NPWT) may achieve infection control, provide angiogenesis, and improve respiratory function. When stable wound conditions have been established a sustainable plastic surgical flap reconstruction should be undertaken.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>This study analyses a method to simplify defect coverage with a single Latissimus Dorsi Myocutaneous Flap (LDMF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Preparation of 20 LDMF in ten fresh frozen cadavers was conducted. Surgical steps to increase pedicle length were evaluated. The common surgical preparation of LDMF was compared with additional transection of the Circumflex Scapular Artery (CSA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Alteration of the surgical preparation of LDMF by sacrificing the CSA may provide highly valuable well-vascularized muscle tissue above the sensitive area of the Xiphisternum. All defects could be completely reconstructed with a single LDMF. The gain in length of flap tissue in the inferior third of the sternum was 3.86\u00b10.9\u200acm (range 2.2 to 8\u200acm).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec specific-use=\"heading-level-1\">\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>By sacrificing the CSA in harvesting the LDMF a promising gain in length, perfusion and volume may be achieved to cover big sternal defects with a single flap.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/ch-238115","type":"journal-article","created":{"date-parts":[[2023,9,22]],"date-time":"2023-09-22T11:41:42Z","timestamp":1695382902000},"page":"225-236","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extended arc of rotation of Latissimus Dorsi Musculocutaneous Flap providing well-vascularized tissue for reconstruction of complete defects of the sternum: An anatomical study of flap pedicle modification"],"prefix":"10.1177","volume":"86","author":[{"given":"Carsten","family":"Ernert","sequence":"first","affiliation":[{"name":"Department of Plastic, Hand and Microsurgery, Ev. Waldkrankenhaus Spandau, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heike","family":"Kielstein","sequence":"additional","affiliation":[{"name":"Martin Luther University Halle Wittenberg","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argine","family":"Azatyan","sequence":"additional","affiliation":[{"name":"G\u00f6rlitz Hospital","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Prantl","sequence":"additional","affiliation":[{"name":"University Medical Center","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Kehrer","sequence":"additional","affiliation":[{"name":"University Medical Center","place":["Germany"]},{"name":"Ingolstadt Hospital","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,9,16]]},"reference":[{"key":"e_1_3_1_2_2","first-page":"34","article-title":"Overview and Management of Sternal Wound Infection","volume":"25","author":"Kimberly Singh EA","year":"2011","unstructured":"Kimberly SinghEA, Garrett HarpeJ. Overview and Management of Sternal Wound Infection. Semin Plast Surg. 2011;25:34\u201342.","journal-title":"Semin Plast Surg"},{"issue":"5","key":"e_1_3_1_3_2","first-page":"443","article-title":"Surgical management of infected median sternotomy: closed irrigation vs","volume":"26","author":"Acinapura AJ","year":"1985","unstructured":"AcinapuraAJ, GodfreyN, RomitaM, CunninghamJJr, AdamsPX, JacobowitzIJ, et al. Surgical management of infected median sternotomy: closed irrigation vs. muscle flaps. The Journal of Cardiovascular Surgery26(5):1985;443\u20136.","journal-title":"muscle flaps. The Journal of Cardiovascular Surgery"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60767-9"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62300-4"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313480006600215"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.728577"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1710569"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2019.05.024"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s003910050174"},{"issue":"3","key":"e_1_3_1_11_2","first-page":"7","article-title":"Comorbidity trends in patients requiring sternectomy and reconstruction","volume":"54","author":"Ahumada LA","year":"2005","unstructured":"AhumadaLA, de la TorreJI, RayPD, Espinosa-de-Los-MonterosA, LongJN, GrantJH, 3rd, et al. Comorbidity trends in patients requiring sternectomy and reconstruction. Annals of Plastic Surgery.264-8; discussion. 2005;54(3):7.","journal-title":"Annals of Plastic Surgery.264-8; discussion"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1532\/HSF98.20071079"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199907000-00005"},{"key":"e_1_3_1_14_2","doi-asserted-by":"crossref","unstructured":"SeilerWO [Chronic wounds: supplementation for better healing of ulcers]. MMW Fortschritte der Medizin. 2012;154 Spec No 3:99-102; quiz 3.","DOI":"10.1007\/s15006-012-0457-9"},{"issue":"01","key":"e_1_3_1_15_2","first-page":"S51","article-title":"[Treatment of Sternal Osteomyelitis after Median Sternotomy in 130 Patients with Pedicled Myocutaneous Latissimus Flap]","volume":"143","author":"Pech T","year":"2018","unstructured":"PechT, KaniaA, FehlbergW, KalffJC, WalgenbachKJ, BuschKH. [Treatment of Sternal Osteomyelitis after Median Sternotomy in 130 Patients with Pedicled Myocutaneous Latissimus Flap]. Zentralblatt fur Chirurgie. 2018;143(S 01):S51\u2013S60.","journal-title":"Zentralblatt fur Chirurgie"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62035-8"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-26691"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6896(03)00052-1"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2015.11.011"},{"issue":"5","key":"e_1_3_1_20_2","first-page":"376","article-title":"The effects of median sternotomy and internal mammary artery takedown on sternal blood flow","volume":"45","author":"Shriver CD","year":"1988","unstructured":"ShriverCD, SeyferAE, MillerT, GraeberG, GarciaVF. The effects of median sternotomy and internal mammary artery takedown on sternal blood flow. Curr Surg. 1988;45(5):376\u20139.","journal-title":"Curr Surg"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(98)00087-3"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(90)90136-T"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2012.11.068"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/0218492312466251"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199610000-00008"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.04.085"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200103000-00008"},{"issue":"3","key":"e_1_3_1_28_2","first-page":"211","article-title":"A technique for the treatment of sternal infections using the Vacuum Assisted Closure device","volume":"4","author":"Hersh RE","year":"2001","unstructured":"HershRE, KazaAK, LongSM, FiserSM, DrakeDB, TribbleCG. A technique for the treatment of sternal infections using the Vacuum Assisted Closure device. The Heart Surgery Forum. 2001;4(3):211\u20135.","journal-title":"The Heart Surgery Forum"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.121306"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000200620.77353.40"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1275170"},{"key":"e_1_3_1_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199106000-00008"},{"issue":"4","key":"e_1_3_1_33_2","first-page":"433","article-title":"Total excision of the sternum and thoracic pedicle transposition of the greater omentum; useful strategems in managing severe mediastinal infection following open heart surgery","volume":"80","author":"Lee AB SG","year":"1976","unstructured":"LeeAB SGJr, ShaktinS, SeigelJH. Total excision of the sternum and thoracic pedicle transposition of the greater omentum; useful strategems in managing severe mediastinal infection following open heart surgerySurg Gynecol Obstet. 1976;80(4):433\u20136.","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2009.01.057"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(89)90013-1"},{"key":"e_1_3_1_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000253443.09780.0f"},{"key":"e_1_3_1_37_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812463320"},{"key":"e_1_3_1_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00104-016-0218-x"},{"key":"e_1_3_1_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/micr.22405"},{"key":"e_1_3_1_40_2","unstructured":"TansiniI Sopra il mio nuevo processo di amputazione della mammella. Gazzetta Medica Italiana. 1906."},{"key":"e_1_3_1_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198167020-00007"},{"key":"e_1_3_1_42_2","unstructured":"OlivariN The Latissimus Flap. Brit J Plast Surg. 1976."},{"key":"e_1_3_1_43_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197964050-00009"},{"issue":"2","key":"e_1_3_1_44_2","first-page":"111","article-title":"The latissimus dorsi flap, experience with 51 operations","volume":"79","author":"Olivari N","year":"1980","unstructured":"OlivariN. The latissimus dorsi flap, experience with 51 operations. Acta Chir Belg. 1980;79(2):111\u20134.","journal-title":"Acta Chir Belg"},{"key":"e_1_3_1_45_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197964050-00013"},{"issue":"5","key":"e_1_3_1_46_2","first-page":"899","article-title":"Sternal blood flow after median sternotomy and mobilization of the internal mammary arteries","volume":"104","author":"Seyfer AE","year":"1988","unstructured":"SeyferAE, ShriverCD, MillerTR, GraeberGM. Sternal blood flow after median sternotomy and mobilization of the internal mammary arteries. Surgery. 1988;104(5):899\u2013904.","journal-title":"Surgery"},{"key":"e_1_3_1_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.04.061"},{"key":"e_1_3_1_48_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy289"},{"key":"e_1_3_1_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60030-6"},{"key":"e_1_3_1_50_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31823b67ec"},{"issue":"6","key":"e_1_3_1_51_2","first-page":"725","article-title":"Chest wall reconstruction","volume":"199","author":"Arnold PG","year":"1984","unstructured":"ArnoldPG, PairoleroPC. Chest wall reconstruction. Experience with 100 consecutive patients. Annals of Surgery. 1984;199(6):725\u201332.","journal-title":"Experience with 100 consecutive patients. Annals of Surgery"},{"key":"e_1_3_1_52_2","doi-asserted-by":"publisher","DOI":"10.1007\/s001040051194"},{"key":"e_1_3_1_53_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196906000-00011"},{"key":"e_1_3_1_54_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199802000-00013"},{"key":"e_1_3_1_55_2","doi-asserted-by":"publisher","DOI":"10.1080\/02844310310000455"},{"issue":"6","key":"e_1_3_1_56_2","first-page":"738","article-title":"Infected median sternotomy wound","volume":"191","author":"Jurkiewicz MJ","year":"1980","unstructured":"JurkiewiczMJ, BostwickJ, 3rd, HesterTR, BishopJB, CraverJ. Infected median sternotomy wound. Successful treatment by muscle flaps. Annals of Surgery. 1980;191(6):738\u201344.","journal-title":"Successful treatment by muscle flaps. Annals of Surgery"},{"issue":"7","key":"e_1_3_1_57_2","first-page":"732","article-title":"[Reconstruction of infected median sternotomy wound dehiscence after coronary artery revascularization]","volume":"20","author":"Kuang B","year":"2006","unstructured":"KuangB, ChenY, DengG. [Reconstruction of infected median sternotomy wound dehiscence after coronary artery revascularization]. Zhongguo xiu fu chong jian wai ke za zhi=Zhongguo xiufu chongjian waike zazhi=Chinese journal of reparative and reconstructive surgery. 2006;20(7):732\u20134.","journal-title":"Zhongguo xiu fu chong jian wai ke za zhi=Zhongguo xiufu chongjian waike zazhi=Chinese journal of reparative and reconstructive surgery"},{"issue":"766","key":"e_1_3_1_58_2","article-title":"Management of the infected median sternotomy wound with muscle flaps: The Emory 20 year experience","volume":"225","author":"Jones G","year":"1997","unstructured":"JonesG, JurkiewiczMJ, BostwickJ, et al. Management of the infected median sternotomy wound with muscle flaps: The Emory 20 year experience. Ann Surg. 1997;225(766).","journal-title":"Ann Surg"},{"key":"e_1_3_1_59_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-200103000-00007"},{"key":"e_1_3_1_60_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2007.00371.x"},{"issue":"3","key":"e_1_3_1_61_2","first-page":"209","article-title":"[Chest wall reconstruction with rectus abdominis musculocutaneous flap for sternum osteomyelitis after radiation]","volume":"65","author":"Chikaishi Y","year":"2012","unstructured":"ChikaishiY, NoseN, IchikiY, YasudaM, NagashimaA. [Chest wall reconstruction with rectus abdominis musculocutaneous flap for sternum osteomyelitis after radiation]. Kyobu geka The Japanese Journal of Thoracic Surgery. 2012;65(3):209\u201312.","journal-title":"Kyobu geka The Japanese Journal of Thoracic Surgery"},{"key":"e_1_3_1_62_2","doi-asserted-by":"publisher","DOI":"10.3233\/CH-189411"},{"issue":"1","key":"e_1_3_1_63_2","first-page":"37","article-title":"Vasopressor support vs","volume":"69","author":"Anker AM","year":"2018","unstructured":"AnkerAM, PrantlL, StraussC, BrebantV, HeineN, LambyP, et al. Vasopressor support vs. liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction - a randomized controlled trial. Clin Hemorheol Microcirc. 2018;69(1-2):37\u201344.","journal-title":"liberal fluid administration in deep inferior epigastric perforator (DIEP) free flap breast reconstruction - a randomized controlled trial. Clin Hemorheol Microcirc"},{"key":"e_1_3_1_64_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.05.011"},{"key":"e_1_3_1_65_2","unstructured":"GordonA AlsayouriK Anatomy Shoulder and Upper Limb Axilla. StatPearls. Treasure Island (FL)2020."},{"issue":"6","key":"e_1_3_1_66_2","first-page":"636","article-title":"Haemodynamic enhancement in perforator flaps: the inversion phenomenon and its clinical significance","volume":"59","author":"Rubino C","year":"2006","unstructured":"RubinoC, CosciaV, CavazzutiAM, CanuV. Haemodynamic enhancement in perforator flaps: the inversion phenomenon and its clinical significance. A study of the relation of blood velocity and flow between pedicle and perforator vessels in perforator flaps. J Plast Reconstr Aesthet Surg. 2006;59(6):636\u201343.","journal-title":"A study of the relation of blood velocity and flow between pedicle and perforator vessels in perforator flaps. J Plast Reconstr Aesthet Surg"},{"key":"e_1_3_1_67_2","doi-asserted-by":"publisher","DOI":"10.3233\/CH-168105"},{"key":"e_1_3_1_68_2","doi-asserted-by":"crossref","unstructured":"KehrerA HeidekruegerPI LonicD TaegerCD KleinS LambyP et al. High-Resolution Ultrasound-Guided Perforator Mapping and Characterization by the Microsurgeon in Lower Limb Reconstruction. J Reconstr Microsurg. 2020.","DOI":"10.1055\/s-0040-1702162"}],"container-title":["Clinical Hemorheology and Microcirculation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/CH-238115","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3233\/CH-238115","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/CH-238115","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T15:06:33Z","timestamp":1777388793000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/CH-238115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,16]]},"references-count":67,"journal-issue":{"issue":"1-2","published-print":{"date-parts":[[2024,2,22]]}},"alternative-id":["10.3233\/CH-238115"],"URL":"https:\/\/doi.org\/10.3233\/ch-238115","relation":{},"ISSN":["1386-0291","1875-8622"],"issn-type":[{"value":"1386-0291","type":"print"},{"value":"1875-8622","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,16]]}}}