Omental transfer as the strategy for postoperative deep wound infection

This is the authors' abstract. We don't add key points for this paper.

I read with great interest the article by van Wingerden and associates [1]. They concluded that the weight of current evidence is insufficient to prove the superiority of reconstruction with muscle flaps over omental transfer, and that use of the omentum may be associated with lower mortality and fewer complications. Both muscle and omental flap transfers have merits and demerits per se as the authors mentioned. We have some experience of post-sternotomy deep sternal wound infection (DSWI) [2, 3]. Our surgical treatment strategy for serious complications is omental transfer. The omentum not only has a mass effect, filling the dead space remaining after curettage and debridement of infected tissue, but also unique properties such as the enhancement of neovascularization and the ability to absorb exudates. Today, our initial procedure for DSWI is vacuum-assisted closure treatment followed by omental transfer [4]. Muscle flaps could occupy the dead space where bacterial contamination might take place, but their properties of neovascularization and absorbing exudates, which the omentum has, have not been sufficiently proven. Thus, we prefer omental flap transfer over muscle flap transfer for the treatment of DSWI.