PMC9994661_01
Preoperative: (A) defect on the anterior chest wall with scar-like hypopigmented skin and supraumbilical raphe; (B) marked V-shaped sternal defect.
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An endotracheal tube was inserted, and the neck and sternal defect area were cleaned and draped (Figure 2A and B).
Intraoperative: (A) vertical incision was made, followed by raising skin flap; (B) exposing sternal bars and pectoralis major muscle flaps. The two halves were freed of underlying pleura and pericardium.
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Skin flaps were raised on both sides, sternal bars exposed, and substernal, pleural, and mediastinal spaces freed by blunt dissection (Figure 3A and B).
Immediately postprocedure: (A) approximation of sternal bars and muscle flaps done; (B) complication of inward chest retraction is not seen.
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Approximation of the sternal bars with PDS number 2 was done and observed, and no cardiovascular compromise was seen (Figure 4A and B).
Postoperative: (A) the incision closed layer by layer, cleaned; (B) observed for infection at 2-7 days; (C) at discharge.
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The incision was closed layer by layer (Figure 5A-C).