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OBJECTIVE: We studied the results of plastic surgical reconstruction of chronic discharging sinuses of chest wall and sternum.
METHODS: 12 patients presented with chronic discharging sinuses of chest wall and sternum. All had failed previous medical therapy. Surgical intervention with tracking of sinus, extensive debridment of bone, cartilage and soft tissue was performed. Defects were filled in with muscle flap (pectoral, latissimus dorsi, rectus abdominus) and pedicle omental flap.
RESULTS: 12/12 had complete resolution of chronic discharging sinuses. Histopathology confirmed TB granulomatous change in 10 patients. Antituberculous treatment was started in these patients. There was no recurrence of sinus. There was no mortality in this group. Mean blood loss was 224 ml. resolution of skin excoriation was seen in all patients.
CONCLUSIONS: Aggressive surgical debridement with plastic surgical reconstruction gives good clinical outcome in patients with chronic discharging chest wall sinuses.