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©2013 UpToDate ® Print Email Bilateral pectoralis flap to fill sternal defect (A) Bilateral pectoralis major flap dissection. The dashed vertical black line indicates the extent of undermining and dissection of the pectoralis major muscle needed to extend it over the sternum. (B) Bilateral medial advancement and placement over mediastinal defect. Reproduced with permission from: Orgill DP, Austen WG, Butler CE, et al. Guidelines for Treatment of Complex Chest Wounds with Negative Pressure Wound Therapy [review]. Wounds 2004; Suppl B: A compendium of clinical research and practice. Copyright © 2004 HMP Communications, LLC.