Internal Mammary Artery Perforator Flap to Cover Sternotomy Wounds: A Prospective Study: Internal Mammary Artery Perforator Flap to Cover Sternotomy Wounds

Muhammad Bilal; Imran Shahzad; Kamran Khalid; Farrukh Aslam Khalid; Abdul Malik Mujahid; Ahmad Saeed

doi:10.54393/pjhs.v7i6.3950

Authors

Muhammad Bilal Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore, Pakistan
Imran Shahzad Department of Plastic Surgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Kamran Khalid Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore, Pakistan
Farrukh Aslam Khalid Department of Plastic Surgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan
Abdul Malik Mujahid Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Centre, Allama Iqbal Medical College, Lahore, Pakistan
Ahmad Saeed Department of Plastic Surgery, Royal Devon and Exeter Hospital, Devon, United Kingdom

DOI:

https://doi.org/10.54393/pjhs.v7i6.3950

Keywords:

Internal Mammary Artery Perforator Flap, Sternotomy Wound, Mediastinal Defect, Conventional Reconstructive Flaps

Abstract

The issue of sternotomy wounds is a continued challenge in cardiac and thoracic vascular surgery, especially in patients who have various comorbidities and are infected. Functional morbidity is linked to traditional muscle flaps that are effective. IMAP flap provides an alternative to other conventional flaps and the internal mammary perforator (IMAP) flap, which maintains muscle functionality while also producing well-vascularized tissue. Objectives: To determine the clinical results of the internal mammary artery perforator flap to reconstruct presternal and mediastinal sternotomy wound defects. Methods: This prospective observational study was conducted during the period of August 2024 and February 2025 at the Department of Plastic Surgery, Jinnah Burn Reconstruction Surgery Centre/Allama Iqbal Medical College. Institutional ethical approval was obtained No.6117/ED/JB&RSC. Results: In this study, the mean age of the cases was 56.4 ± 10.8 years. There were 21 (70%) males and 9 (30%) females enrolled. Complete reconstructive success was achieved in 10 patients, partial success was achieved in 15 patients, and non-healing wounds were found in 5 patients. Recurrent infection was found in 5 patients (16.7%), and mortality associated with sepsis was observed in 4 patients (13.3%). Conclusions: IMAP flap is a secure reconstruction of the defects present on the presternal and mediastinal sternotomy wounds, which has a good healing outcome even in high-risk patients. IMAP flap is a better alternative to the conventional muscle flap for chest wound coverage.

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