The Latissimus Dorsi Myocutaneous Flap for the Exposed Cardiac Pacemaker in Children

The Latissimus Dorsi Myocutaneous Flap for the Exposed Cardiac Pacemaker in Children

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Exposure of a cardiac pacemaker implanted subcutaneously in the infraclavicular region is a difficult problem facing the plastic surgeon.The principles of treatment for salvage are control of sepsis, extensive debridement and tension free closure with locoregional flaps.Management in children is complicated by the fact that the pacing unit BODY LOTION is of the same size as in the adult and there is little laxity of tissue in this age group.We have treated 7 children and have utilised the latissimus dorsi myocutaneous flap for salvage in 4 patients.Local skin flaps were employed in 2 children while a primary closure was possible in 1 child.

Six patients have remained healed over a follow up period ranging from 6 Ghee months to 60 months.In one case we have had to explant the unit at 3 months due to persisting sepsis.Salvage of pacemakers should be attempted in all patients with pacemaker exposure.The latissimus dorsi myocutaneous flap that we have employed is a useful option when faced with this problem in children.